Partnering with community-based organizations and a well-respected commercial partner in Massachusetts, and backed by the top healthcare investors in the country, we are reorganizing the health system to focus on what matters to our members—and leading the move from transactional, fee-for-service medicine towards high-value, relationship-based partnerships.
In this role, you will provide direct service to Cityblock members as part of our innovative care model, designed to address the complex health and social challenges of high-risk, high-need populations living in urban neighborhoods. You will be working in and out of our Neighborhood Hub, a primary care practice in Worcester area. Your work will sometimes be home-based, extending out in the surrounding neighborhood and community, and at other times, will be centered in the Hub. It is integral to our care model that we meet people where they are, both physically and emotionally.
As a Primary Care Physician, you will work with a panel of members in a value-based care environment as part of a tailored interdisciplinary team, leading the development and delivery of our care model and improving the health and wellbeing of our members.
• Manage a panel of members to provide diagnosis, treatment, counseling, medication management, acute triage and follow up care
• Partner with other members of the care team, providing physical health clinical support and collaborating closely with Behavioral Health Specialists and Community Health Partners, among others
• Foster lasting and trusting relationships with individuals, their families and caregivers, and communities
• Work with members longitudinally to achieve their goals.
• Identify and collaborate closely with existing outpatient behavioral health providers, primary care providers and specialists
• Advocate for your members and engage with the community
• Go above and beyond to connect with people in a non-judgmental, respectful and empathic manner, to meet their needs, and to provide feedback to the system as a whole as we strive to do better every day
• Work daily within our custom-built care facilitation platform, Commons, which will enable you to collect data, organize information, track tasks, and communicate with staff, patients, and family. This platform is optimized for a mobile workforce, and you will be among the first cohort to field-test our technology, provide feedback to the product development team, and, over time, become part of a super-user group to assist in onboarding and supporting others
You'd be a good fit if:
• You are an MD or DO, Board Certified in Internal Medicine, Family Medicine, or Medicine-Pediatrics with an unrestricted license to practice in the state of Massachusetts
• You have experience providing direct care to underserved populations with complex needs
• You are an independent self-starter, a leader, and a strategic thinker who is excited about the big picture of whole community health, and the ongoing evaluation and iteration of our care model
• You have experience working within an interdisciplinary team
• You are excited about how technology can support your work and help drive the ongoing evaluation toward new, better, care
• You are passionate about improving care delivery
Nice to have:
• Experience working with individuals with co-occurring chronic medical and chronic behavioral health diagnoses.
• X-waiver to provide medication assisted therapy for opioid use disorder
• Experience caring for individuals experiencing homelessness
• Experience caring for individuals with criminal justice involvement