Under the direction of the department chief, the incumbent is Physician Assistant who travels to patient homes for a majority of their work week using their advanced training/skills in assessing, diagnosing, and treating the patient with both chronic and acute illness and disease. Works in a collaborative team practice that recognizes the patient as the central focus. Serves as a patient educator in areas of specialization. Visits patients with complex health needs who have not engaged with Atrius in accordance with their clinical status. GENERAL DUTIES AND RESPONSIBILITIES Diagnoses and treats acute and chronic illnesses that are of an appropriate level of complexity for the knowledge and experience of the NP. Escalates chronic illness issues to the PCP. 2-4 days a week the APC will go to visit patient home to provide a point of care (i.e. any non-Atrius off-site location) assessment Conducts multiple home visits a day for 45-60 minutes Orders and interprets laboratory work and other diagnostic studies. Develops and implements a plan of care to address the illness, which may include prescribing medications and/or other treatments. May refer patient to subspecialty physicians. Provides home-based transition of care visits with challenges coming into the office following a hospital or SNF stay Document timely with an added focus on closing HEDIS quality gap measures and recapturing HCCs Teaches and counsels individuals and groups about specific health care needs. Serves as an educator in areas of specialization (e.g. family planning, weight loss, smoking cessation). Develops and implements a comprehensive plan of care for these patients, taking into account social, emotional, and developmental needs, as well as all current medical management practices. Communicates issues related to patient care with PCP. Collaborates with PCP in provision of patient care. Participates in department and organizational clinical care initiatives. Maintains BLS certification. Performs other duties as assigned. EDUCATION/LICENSES/CERTIFICATIONS: Graduate of a State-approved school of Physician Assistant required. Possess a current license to practice in the Commonwealth of Massachusetts, and authorization to practice in the expanded role. Possession and maintenance of or eligibility for DEA and Mass DPH Controlled Substances Registration. American Heart Association Basic Life Support (BLS) required. Advanced Cardiac Life Support (ACLS) may be required based on specialty. EXPERIENCE: 2 years clinical NP experience in IM, Geriatrics, Primary Care, ED, Urgent Care, or similar setting. Experience with capturing HCCs. Experience with an electronic medical records system, EPIC experience preferred. Experience visiting patients in their homes preferred. IND1 Job Type: Full-time Pay: $130,676.00 - $138,950.00 per year Benefits: 401(k) 401(k) matching Dental insurance Flexible schedule Flexible spending account Health insurance Life insurance Paid time off Retirement plan Tuition reimbursement Vision insurance Medical Specialty: Internal Medicine Primary Care Education: Master's (Required) Experience: Epic: 1 year (Required) Primary care: 2 years (Required) EMR systems: 1 year (Required) Physician assistant: 2 years (Required) License/Certification: ACLS Certification (Required) Driver's License (Required) PA-C (Required) Ability to Commute: Boston, MA (Required) Work Location: On the road