Fallon Health·Springfield, Massachusetts
Manages a primary care panel for PACE participants, focusing on person-centered care, disease prevention, and chronic illness management. Collaborates with an interdisciplinary team to develop and implement individualized care plans and conduct home visits.
Primary Job Responsibilities (include duties that represent 5% or more of employee's time) Performs post enrollment visits, biannual exams of participants and appropriately identifies and documents problems/issues in medical records Evaluates episodic illnesses and issues appropriate diagnostic and therapeutic orders Collaborates with physicians and other interdisciplinary team members to manage episodic and chronic medical needs of participants Addresses and documents Advance Directives/MOLST discussion for participants a minimum of annually and when a change in participant condition occurs Performs diagnostic, therapeutic and nursing intervention as indicated Provides continuity in monitoring of chronic, stable illnesses Implements the participant plan of care in a safe and effective manner Participates in interdisciplinary team meetings Evaluates effectiveness of previously implemented treatment Conducts home and nursing home visits as indicated Maintains accurate documentation and coding of all services provided according to professional standards Identifies utilization and service delivery problems and participates in identifying a resolution Identifies grievances and brings forward to leadership Participates in quality assessment activities including but not limited to record reviews, outcome measurement and review/revision of policies and procedures Provides education and training to participants, caregivers and staff in relevant topics Acts a resource to program staff and participates in defining care standards and practices Serves on appropriate committees, participates in all site and provider staff meetings including behavioral rounds and psychiatric rounds as indicated. Enhances personal professional growth and self-development through participation in professional activities including educational programs, current literature, in-service programs, trainings and workshops. Maintains BLS certification and professional certification as appropriate. May be asked to perform other duties that align with Fallon Health’s mission, including but not limited to participation on clinical committees, providing education, quality initiatives and/or other activities.
Education: Master’s degree required. Graduate of an accredited Nurse Practioners program License/Certifications: Licensed by the Commonwealth of Massachusetts Board of Registration in Nursing. Driving your personal motor vehicle is an essential job function of this position and the following requirements apply: Must possess a valid drivers’ license Must attest to no disqualifiers per Driver Safety Policy Must possess and provide proof of minimal state required auto insurance Must have reliable transportation Experience: One to three years of Nurse Practitioner experience preferred with at least one year of experience in geriatric care. Experience working in a healthcare setting as a member of a professional clinical team. Experience with care coordination.
Requires a Master's degree from an accredited Nurse Practitioner program and licensure by the Massachusetts Board of Registration in Nursing. Preferred experience includes one to three years as a Nurse Practitioner with at least one year in geriatric care.
Market context
In Massachusetts, nursing roles often draw steady demand, especially in specialty settings like oncology where prior RN experience can matter. These positions are competitive because employers commonly look for an active RN license, an ADN at minimum, and prefer candidates with oncology background and a BSN. Review the AI-summarized requirements and benefits on this platform to save time, then tailor your application to highlight oncology experience, licensure, and any relevant advancement or recognition achievements.
