CareSource·Massachusetts
Provides comprehensive primary care and clinical coordination for patients with complex medical, behavioral, and social needs. Responsibilities include conducting annual visits, managing chronic diseases, and performing post-discharge follow-ups to reduce hospital readmissions.
The Care Delivery Advanced Practice Clinician (APC) provides comprehensive primary care and clinical care coordination to a panel of patients, including individuals with significant medical, behavioral, and social complexities that require intensive care coordination and care delivery. This role provides ongoing chronic disease consultation and management, promotes preventative care through education and identification of age-appropriate preventative screens, provides urgent care, and acts as a liaison with other health professionals as needed.
Essential Functions
Performs longitudinal primary care and wrap-around care including routine, and urgent care for an attributed patient panel in clinic, through home visits, and utilizing telehealth technologies (video, chat, etc.).
Facilitates and delivers preventative care to patients according to guidelines deemed appropriate by Clinical Leadership.
Conduct Annual Visits with patients, taking a detailed history, performing a physical examination, and documenting appropriate diagnoses to develop a comprehensive medical care plan and ensure capture of high-risk diagnoses under CMS guidelines.
Performs episodic urgent medical visits to ensure that patients are given timely and appropriate medical care to avoid emergency room visits or hospitalization.
Prescribes medically necessary and appropriate medications and treatments, in consultation with the physician where needed, including prescribing medication assisted treatment (MAT) for some conditions when clinically appropriate.
Performs post discharge visits on patients within two weeks of discharge from either an acute care facility or a skilled nursing facility with the goal of decreasing admissions and re-admission; performs detailed medication reconciliation and adjust medications as indicated.
Collaborates with inpatient or post-acute care team and patient to optimize discharge planning in collaboration with Transitions of Care (done in-person at facility, telephonically, or virtually).
Leverage emergency medical or psychiatric services as indicated to mitigate Emergency Services and inpatient admissions.
Documents all visits with focus on clear, comprehensive, and concise charting to identify, document, and execute a patient-centric plan of care.
Serve as a clinical mentor for medical care.
Proactively and collaboratively work with patients’ Primary Care Provider (PCP) and other external providers to ensure a cohesive medical treatment plan is delivered.
Identify and lead ad-hoc case reviews with internal/external care team as needed.
Participates in committees and workgroups that promote clinical excellence and help to advance the organization's mission and business objectives.
Assists leadership with the development, refinement and enhancement of clinical programs, initiatives, processes, policies, workflows, and projects
Provide clinical coverage for colleagues as needed.
Perform any other job related duties as requested.
Licensure and Certification
Current unrestricted license to practice as a physician assistant from the Board of Registration of Physician Assistants in Massachusetts required or
Current unrestricted license to practice as an advanced practice RN from the Board of Registration in Medicine, which includes valid Massachusetts RN licensure in good standing required
Current Massachusetts Controlled Substances License required
Current DEA Controlled Substances License required
Current CPR or Basic Life Support (BLS) Certification required
Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated
To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.
Employment in this position is conditional pending successful clearance of a criminal background check. If the criminal background results are unacceptable, the offer will be withdrawn or, if employee has started in position, employment in position will be terminated.
$83,000.00 - $132,800.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
This job description is not all inclusive. Caresource reserves the right to amend this job description at any time. Caresource is an equal opportunity employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
Brand=Commonwealth Care Alliance
Requires a Master's degree in Nursing or Physician Assistant Studies with board certification and a valid Massachusetts license. Candidates need experience caring for complex patient populations and must possess a valid driver's license and vehicle.
Market context
Advanced-practice openings in Massachusetts often reflect steady demand in long-term care and skilled nursing settings, where licensed NPs, PAs, and physicians can support complex patient needs. These roles are competitive because employers usually want an active Massachusetts license plus recent facility experience, and this platform’s AI-summarized requirements and benefits help you review the original posting faster. If you are applying, confirm your license status and highlight any long-term care or SNF experience clearly in your resume.
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