Responsibilities

The Geriatric/Internal Medicine Physician is responsible for providing quality care for Grand View Health patients that fall under the physician's field of training, including, but not limited to, diagnosis, treatment, coordination of care, preventive care and health maintenance for all patients. In addition, the physician is responsible for promoting the GVH mission, vision and values, as well as collaboratively working with team members at all levels to achieve them. They must be cognizant of, and comply with, all GVH policies and procedures, as well as pertinent state and federal regulations.

There are two positions available that will cross-cover each other. One will be employed by Grand View Health and the other employed by the independent group, TriValley Primary Care.

The TriValley Primary Care (TVPC) physician in the Geriatrics Division is responsible for care of the population in local partnering Continuous Care Retirement Centers (CCRCs), works in tandem with the Geriatric CRNPs, and may represent TriValley Primary Care in leadership positions or committee work with the CCRCs. This physician will report to the TriValley shareholders and collaborates with TriValley geriatrics committee and TriValley executive committee.

Essential Job Functions:

• Treating patients in CCRCs, including independent living, assisted living, long-term nursing care, memory units and skilled nursing care.
  • Obtaining and recording a detailed medical history of each patient, using independent historians as needed.
  • Performing complete physical exams and review of systems, and documenting findings in the electronic medical record.
  • Assessing the medical conditions of each patient, utilizing external testing results and performing additional testing to support the associated diagnoses and plan of care.
  • Referring patients to other physicians, including specialists and other healthcare providers, when necessary.
  • Prescribing medication and treatment for the patient and recommending appropriate physical and dietary routines to support their health.
  • Coordinating and collaborating with CCRC staff to ensure the plan of care is implemented and the needs of the patients are met.
  • Keeping and maintaining electronic patient medical records related to all processional services rendered, locking notes in a timely manner, and billing for all services rendered.
  • Reviewing and attending to all external reports and correspondence pertaining to the patient's plan of care.
  • Participating in discharge planning from CCRCs, collaborating with the facilities, families and available resources to improve transitions of care.
  • Providing coverage when other physicians are unavailable due to vacations, illness or attendance at professional conferences, as well as rotation in on-call coverage for evenings, weekends and holidays.
  • Reporting births, deaths, outbreak of contagious diseases, and other information required in a timely manner to appropriate governmental authorities and as required for TriValley reporting.
  • Advanced care and end-of-life planning with patients, families and caregivers.
• Maintaining licensure and board certification; attending continuing medical education as required.
• Promoting the professional practice of TriValley Primary Care and its affiliates.
• Active participation in value-based contracts, including addressing specified quality metrics, monitoring patients' costs and utilization, engagement with comprehensive care management, and accurately coding and appropriately assessing patients' full medical complexity.
  • Participation in strategic meetings and planning sessions for value-based contracts as they pertain to the CCRC population.
• Performing other duties assigned by TriValley from time to time that are commensurate with the professional services normally and customarily performed by a primary care physician.

Key Decisions:

• Establishing a plan of care appropriate for each patient's conditions and available supports.
• When to refer patients to specialists or other healthcare providers or facilities for additional care.
• When to discharge patients to their community residence.

Key Result Areas/Results Expected:

• Providing excellent care to patients residing in CCRCs.
• Accurately documenting the full complexity of the patients' medical conditions.
• Accurately documenting and billing for all services rendered.
• Ensuring length of stay is appropriate for the medical complexity of each patient.
• Managing hospital readmission risk for patient panel.