APP - Intensive Primary Care

Acclaim Physician Group, Inc. (Acclaim) is a multi specialty medical group practice comprised of over 500 physicians, nurse practitioners, and physician assistants that partner with JPS Health Network (JPS). Acclaim supports JPS’s mission of transforming healthcare delivery for the communities we serve. From primary care to pediatrics to a full range of specialties, Acclaim’s goal is to provide high-quality, compassionate care for every patient, every time. As the county health network and Level-1 Trauma Center, JPS has been serving the residents of Tarrant County for over 100 years. In addition to providing high-quality care, JPS is also an urban teaching hospital with a long history of training physicians and medical students. JPS offers 18 residency and fellowship programs, including the largest family medicine residency in the nation. JPS educates in tandem with the University of North Texas Health Science Center, Texas College of Osteopathic Medicine, and Texas Christian University Medical School. For more information, visit www.teamacclaim.org . Job Title APP - Intensive Primary Care Requisition Number req29487 Location: John Peter Smith Hospital Job Description About Acclaim, A partner with JPS Health Network Acclaim Physician Group, Inc. (Acclaim) is a multi-specialty medical group practice comprised of over 500 physicians, nurse practitioners, and physician assistants that partner with JPS Health Network (JPS). Acclaim supports JPS’s mission of transforming healthcare delivery for the communities we serve. From primary care to pediatrics to a full range of specialties, Acclaim’s goal is to provide high-quality, compassionate care for every patient, every time. As the county health network and Level-1 Trauma Center, JPS has been serving the residents of Tarrant County for over 100 years. In addition to providing high-quality care, JPS is also an urban teaching hospital with a long history of training physicians and medical students. JPS offers 18 residency and fellowship programs, including the largest family medicine residency in the nation. JPS educates in tandem with the University of North Texas Health Science Center, Texas College of Osteopathic Medicine, and Texas Christian University Medical School. For more information, visit www.teamacclaim.org . Advanced Practice Provider – Intensive Primary Care Program Overview The Intensive Primary Care (IPC) program seeks to address the high cost, high need patients of Tarrant County in an effort to improve their health and wellbeing as well as decrease their utilization of high cost low benefit services. In order to accomplish these goals, the program utilizes an integrated, multidisciplinary, outreach based approach. The IPC program acts as a transitional Medical Home for this high risk patient population and delivers innovative, patient centered, comprehensive primary care until the patient can be biomedically and psychosocially stabilized enough to transition to a traditional PCMH. The program specifically targets patients who are currently unfunded or on JPS Connections or Medicare. The majority of visits occur outside of traditional clinic based settings, including home visits, street outreach, and hospital consultations. Specific Details Tuesday – Friday, 7:00am – 6:00pm Triage calls directly from patients Clinical time spent on outreach and home visits Must provide personal transportation (mileage reimbursed) Experience with complex medical care and psychiatric and substance use comorbidities is a plus Duties And Essential Job Functions Perform comprehensive assessment including, medical, psychiatric, and socioeconomic needs and work collaboratively with the patient to develop and implement a comprehensive care plan. Conduct follow up visits when and where needed, as well as address urgent and acute complaints. Revise care plan as needed, and collaborate with patient and community providers to develop and implement a transition to community based primary care when appropriate Collaborates with care team in overseeing and coordinating the multidisciplinary care delivered to all patients, to optimize quality patient care. Reviews patient medical charts with team physician with diagnosis, treatment and care management. Monitors guidelines for the management of care and for ensuring that the services are delivered in compliance with the guidelines established by JPS Health Network and Acclaim Health. Provides care education to patients and families. Provides evidence-based and compas