Posted 5mo ago

Anchor NP: Internal Medicine

@ Codman Square Health Center
Dorchester, Massachusetts, United States
$55-$72/hrOnsiteFull Time
Responsibilities:Provide direct, Care coordination, Inter-visit support
Requirements Summary:NP with 2+ years of experience; fluent in care coordination in primary care; bilingual preferred (Haitian Creole, Spanish, French, Portuguese, or Cape Verdean Creole).
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Job Description

Position Summary:



The Anchor Nurse Practitioner (Anchor NP) is a member and extender of a primary care team that includes primary care providers (PCPs), nurses, medical assistants, and other team members.  The Anchor NP provides direct patient care, supports timely completion of care for the team, and co-manages selected patients with the PCPs and other team members, including the complex care management team, the integrated behavioral health team, and the clinical pharmacy team. The Anchor NP models teamwork, interdisciplinary care, and shared responsibility



The Anchor NP enhances timely access for primary care patients and improves the patient experience for patients on the panels of the PCPs in their department in the below areas, as prioritized by the Department Medical Director:




  • Provide direct patient care as needed or as requested to patients on their team PCPs’ panels. 

  • Provide enhanced access and care coordination to high-risk patients and patients with chronic diseases.

  • Provide inter-visit support for the primary care team, including patient visits and in basket management for unavailable providers during vacations, off days, or sick days. Daily collaboration with nursing team to address timely patient needs.

  • Provide specialized care responsibilities for patients with certain conditions at the discretion of the Medical Director or designee.



 



The Anchor NP may also participate in Urgent Care direct care services, facilitate group medical visits, and support substance use or other specialty care services as requested by the Medical Director.




  • Other duties and/or other locations as assigned



Role & Responsibilities:




  • Direct Care and Care Coordination:  




  • 27 hours per week of Primary Care or other direct clinical care with additional 7 hours of clinical administrative time that includes case management and supervision time for a total of 34 hours.

  • Target Productivity: 1.8 patient visits per clinical hour (approximately 2,000 visits per year)

  • Responsibilities may include:

    • Provide timely and same-day visits for patients unable to see their PCP

    • Co-manage selected patients with PCPs for management of chronic conditions, preventative care, complex care management and improved access.

    • Coordinate care for selected patients with complex care management team, community health workers, behavioral health clinicians, and other team members.



  • Additional direct care responsibilities

    • Provide urgent care, facilitate group medical visits, and support substance use or other specialty care services as requested by the Medical Director.






  • Provide special services including population health coordination for defined patient populations as requested by the Medical Director.

  • Work one weekend session per month in Urgent Care or Primary Care.

  • Work one evening per week.




  • Department Inter-visit Responsibilities:




  • Approximately one hour per day – schedule to be determined with the Medical Director.

  • Responsible for ensuring daily completion of inter-visit care for patients of providers who are unavailable, with a focus on completing today’s work for the primary care team. This will be accomplished through supporting the Nursing Team and collaborating with PCPs.

    • Tasks include but are not limited to: Prescription refills, patient requests and clinical questions, test result management, outside provider or pharmacy calls, and urgent form completion.





 




  • Supervision


    • One hour per week of clinical supervision with collaborating physician.