Physician - Skilled nursing facility (SNFist)

Fallon Health•Worcester, MA

About The Position

The Summit Eldercare skilled nursing facility physician is responsible for providing high-quality, participant-centered care to patients in skilled nursing facilities (SNFs). He/she will manage medically complex, post-acute and long-term care participants residing in Skilled nursing facilities. He/she will be responsible for initial and ongoing care at the assigned SNFs, optimizing participant’s health outcomes, in coordination with the SNF and Summit Eldercare Interdisciplinary team.

Requirements

Medical degree (MD or DO) from an accredited school of medicine
Active and unrestricted medical license in the state of Massachusetts
Board certification in Internal Medicine or Family Medicine
2-3 years’ experience in post-acute care, long-term care or geriatric settings
Strong clinical skills in managing complex, frail patients with multiple chronic medical problems, preferably in Skilled nursing facility setting
Excellent communication and interpersonal skills
Demonstrated ability to work effectively in an interdisciplinary team model, PACE model of care preferred
Proficiency in using electronic medical records (EMR)

Nice To Haves

Geriatric Medicine board certification preferred
Board certification Internal Medicine, Geriatrics or Family Practice preferred
Knowledge in Skilled nursing facility (SNF) regulations and standards of care preferred
Demonstrated ability to work effectively in an interdisciplinary team model, PACE model of care preferred

Responsibilities

Clinical care and oversight
Review and cosign (when required) interdisciplinary documentation to ensure accuracy and regulatory alignment.
Perform duties including, but not limited, to admission H&P, regulatory required physician visits, medications and treatment plans review, signatures on all orders and progress notes.
Manage and coordinate treatment for participants with multiple chronic medical problems, acute/arising conditions, and complex medication regimens
Lead and oversee all transitions, including hospital to SNF, ensuring timely and effective care
Conduct daily or scheduled rounds in assigned skilled nursing facilities (SNFs)
Collaborate closely with the SNF staff i.e. nursing staff, Director of nursing, rehab team, etc.
Coordinate closely with the Summit Eldercare interdisciplinary team members
Participate in daily SE IDT meetings and communications as needed to ensure effective, appropriate, and coordinated care
Communicate effectively with participants, caregivers, facility staff and SE IDT members regarding patient goals, treatment plans and care transitions
Build and sustain trusted relationships with SNF medical directors, Directors of Nursing, and key SNF clinical leaders to enhance care consistency and collaboration between SNFs and Summit Eldercare
Maintain a regular, visible presence in each assigned SNF, promoting physician accessibility and adherence to PACE principles
Partner with hospitalist, SE primary care provider and other team members, to support smooth transitions of care and reduce hospital admissions and readmissions
Collaborate with SE team in meeting related utilization metric and MLR goals
Regulatory compliance
Ensure compliance with all CMS physician services requirements for SNFs, including required visit frequency, supervision requirements, medical oversight, and documentation standards
When applicable, supervise advanced practitioners following state law and CMS regulations
Document all physician visits and orders in compliance with SNF EMR standards and PACE documentation requirements.
Participate in grievances reviews, when applicable, in collaboration with the SE team
Review and co‑sign (when required) interdisciplinary documentation to ensure accuracy and regulatory alignment.
Other
Participate in quality improvement initiatives as opportunity arises