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Immanuel Primary Care Physician - Full Time Days - Immanuel Pathways Central Iowa in Windsor Heights, Iowa

Provides primary care and continuous medical coverage, directly provides services to Immanuel Pathways program participants. Practices collaboratively with the Medical Director and Primary Care Provider (PCP) Nurse Practitioner(s) following protocols developed within the specified Code of State Regulations. Provides participants and their caregivers with instruction and education. Functions as a member of the Interdisciplinary Team (IDT) and informs the IDT of the medical condition of each participant, remaining alert to pertinent input from other team members, participant’s caregivers, as well as documenting changes in a participant’s medical record consistent with documentation policies. Works with Clinical Practice Manager to coordinate scheduling and care for participants in the clinic. Performs rounds in the Immanuel Pathways contracted provider locations (i.e. nursing home, hospital and assisted living). Supports and lives out Immanuel’s Mission and CHRIST Promises.

Key Areas

Key Responsibilities and Duties of the Job

Participant Care


  • Performs initial in-person comprehensive history and physical on new Immanuel Pathways participants.

  • Conducts in-person reassessment semiannually and as needed.

  • Coordinates with the IDT to develop a comprehensive plan of care for each participant. Integrates the primary care treatment plan into the overall plan of care developed by the IDT. Interacts with team members to meet emergent and acute need of participants. Participates in discharge planning for acute and long-term placement.

  • Evaluates and treats participants during acute illness.

  • Refers participants to medical specialist as indicated, communicates and follows up with specialist regarding outcome of visit. Oversees and manages participant’s use of medical specialist and inpatient care.

  • Admits participants to the hospital or coordinates with hospital services; providing primary care responsibilities for medical management and updates to IDT. In conjunction with the hospital, case manager and IDT, plans and coordinates discharge.

  • Manages care of participants in the nursing home: Provides regular visits as dictated by nursing home standards and participant needs. Performs telephone contact with nursing home staff as required; coordinates admits for nursing home participant to hospital when necessary.

  • Functions as a member of the IDT maintaining regular attendance and participates at meetings; communicates participant changes, collaborates on plan of care decisions and coordination for twenty-four (24) hour care delivery.

  • Completes and documents appropriate diagnostic coding.

  • At the direction of the Medical Director, reviews medical outcomes/statistical and utilization data, including reviewing of necessity of hospitalizations, and use of specialists. When problems are identified he/she works with the Medical Director to establish best practices and works with clinical staff and IDT to make appropriate procedural and or operational changes to avoid unnecessary hospitalizations and improve the health of participants.

  • Advises the Medical Director in ways and means to establish better accountability of Immanuel Pathways services to participants and referral sources, keeps Medical Director aware of needed material and human resources as program expands.

  • Supports the Medical Director to develop protocols that will be approved annually, collaboratively working with the Nurse Practitioner. Supports the Nurse Practitioner as a consultation resource who will be available at all times, either on site or by telephone.

  • Participates in rotating night and weekend on-call duty.

Quality / Compliance


  • Assists with the development of policies and procedures for standards of care; performs on-going monitoring and evaluation of patient care practice and service delivery; provides guidance and training to staff regarding medical and quality assurance issues.

  • Participates in and supports Quality Improvement Initiatives.

  • Protects privacy and maintains confidentiality of all company procedures, results and information about employees, participants and families.

  • Follows all Immanuel Pathways Policies and Procedures and Occupational Safety and Health Administration (OSHA) safety guidelines.

  • Complies with state Home Health Licensure regulations for home care.

Professional Activities


  • Attends continuing education classes and required staff/training meetings. Maintains professional licensure and certifications.

  • Provides information about Immanuel Pathways Program to interested individuals and groups in adherence to PACE regulations.



  • May provide coverage for a counterpart at a different Immanuel Pathways PACE site on a fill-in basis for a short duration.

  • Participates in the recruitment and training of Nurse Practitioners. May contribute to performance evaluations.

  • Performs other duties as required or requested.


  • Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) degree is required.

  • Board certified in Internal Medicine, Family Medicine, or Geriatric Medicine is desired.

  • Current state license and DEA registration required.

  • Meets requirements for 42 CRF Part 410.20.


  • One (1) year of experience working with the frail or elderly population required, or completion of job specific training related to working with the elderly population must be completed within the first six months of hire.

  • Three (3) years of practicing medicine in a clinical or hospital setting is required.

Other Requirements-

  • Be legally authorized (currently licensed or if applicable, certified or registered) to practice the job’s functions and actions in the respective state in which he/she is employed.

  • Only act within the scope of his/her authority to practice in the respective state in which he/she is employed.

  • Agree to abide by the philosophy, practices, and protocols of the PACE organization.

  • Job specific competencies for the Primary Care Provider MD will be met prior to assuming participant care.

  • Must have medical clearance for communicable diseases and up-to-date immunizations before having direct participant contact.

  • Basic Life Support (BLS) current certification.

  • Must have a valid driver’s license, proof of insurance and have reliable means of transportation.

  • Incumbent may be asked to cover for a counterpart at a different Immanuel Pathways PACE site on a fill-in basis for a short duration.

KSA- Knowledge Skills and Abilities-

  • Knowledge of current concepts, theories and practices related to home and community-based care for the elderly and disabled adults.

  • Knowledge of health care delivery and financing systems, including Medicaid, Medicare, waiver programs, prospective and systems with a monetary cap, public health programs and Health Maintenance Organization (HMO)/Managed Care.

  • Knowledge of the PACE regulations.

  • Knowledge of local/state healthcare and aging networks; in the respective state in which he/she is employed.

  • Knowledge of physical, mental, and social needs of the frail elderly and their families.

  • Knowledge of the various disciplines to assess the needs of the elderly population.

  • Skilled in establishing and maintaining effective working relationships with participants, co-workers and the public.

  • Skilled in oral and written communication.

  • Skilled in organizing time, priorities, and duties.

  • Ability to lead and work within the interdisciplinary setting.

  • Ability to supervise medical staff effectively.

  • Ability to manage changing priorities per needs of the PACE program and the agency.

  • Ability to chart via Electronic Health Records.

  • Proven experience and basic computer proficiency (Microsoft Office, internet, email, and calendar).

Posting Title: Primary Care Physician - Full Time Days - Immanuel Pathways Central Iowa

Job ID: 2019-3676

External Company URL:

Street: 7700 Hickman Road