Advanced Practice Provider - Pre/Post Surgical Optimization
 Mass General Brigham Community Physicians | |
 United States, Massachusetts, Somerville | |
| 399 Revolution Drive (Show on map) | |
 Feb 23, 2026 | |
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Key Responsibilities:
-Seek and maintain personal knowledge regarding perioperative optimization and associated problems to provide accurate resource information to patients -Maintain clinical competency, professional skills, and knowledge through experiences and formal continuing education programs and independent learning activities -Responsible for maintenance of all certifications/licensures required to fulfill duties of the position. -Willingness to collaborate with hospital colleagues and outside healthcare resources are essential -Foster communication between TEAM program staff and other health care team members -Participates in the assessment, development, implementation, and evaluation of quality improvement programs, standards of practice, and policies and procedures. -Fulfill duties to ensure seamless patient care as requested by medical director -Other Administrative Duties: as necessitated by program development and at the direction of leadership. Clinical Care -Provide both virtual and in-person direct patient care and education to TEAM patients -Provide support for all clinical needs of the multidisciplinary TEAM program team -Conduct comprehensive pre-operative geriatric assessments and pre-op optimization screen related to mobility, frailty and support at home -Place lab, and DME orders as indicated for TEAM pathways -Enter referrals for imaging as indicated for TEAM pathways -Enter referral to specialists as indicated for TEAM pathways -Document assessment data, orders, interventions, results and evaluations within the patient's medical record per established standards -Documentation is consistently complete, accurate, timely and legible in accordance with departmental policies and procedures -Drive early patient engagement to support safe discharge Care Coordination and Escalation -Provide clinical oversight of day-to-day team functions (including refinement of protocols, procedures and policies) -Serve as escalation pathway for CMS TEAM coordinators and PT Navigators -Collaborate with local surgical or inpatient teams as indicated -Assist in development and optimization of care pathways, perform PDSA and other process improvement tools Intra-visit and Post-operative Patient Care and Support -Provide information, education, and support to patients and families; include them in planning discussions, with a focus on discharge home -Respond to ongoing patient questions -Manage additional referrals and pre-op optimization needs -Conduct follow-up engagement as indicated -Elicit goals and values from patients and families to better guide them in care plans -Answers telephone calls/messages from patients, family members and clinical staff Documentation and Risk Capture -Complete review and documentation of patient conditions in alignment with PHSO risk capture team -Use standardized tools for risk/ discharge destination -Bill for activities via required billing pathway -Compliance with MGB billing standards What You'll Bring Qualifications: - Advanced Practice Registered Nurse (APRN-NP) or Physician Assistant (PA) licensure required - More than 2 years of licensed experience required. - Experience in perioperative medicine and/or geriatrics preferred. - Skilled in taking medical histories to assess medical condition and interpret findings. - BLS required (or secured within the first 3 months of employment) al issues efficiently and effectively with minimal supervision Schedule and Work Model - Full time, Monday through Friday, standard business hours. - This will be a hybrid role starting with a minimum of 3 days in-person per week at on-site. - Anticipated Schedule:
Mass General Brigham Community Physicians, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. | |