Nurse Practitioner/Physician Assistant -Transitional Care Management

Buffalo Medical Group is one of Western New York's largest premier, multispecialty practices, we're always looking for people who share our commitment to quality patient-centered healthcare. We are currently seeking a Full Time Nurse Practitioner or Physician Assistant for Transitional Care Management to join the Group. Patients will be seen at all BMG locations in Williamsville, Lockport, Orchard Park and Downtown Buffalo.

Schedule:

Full Time - Monday through Friday 8:00am - 4:30pm Job duties include, but are not limited to: Clinical Care Conduct in-person Transitional Care Management (TCM) visits for recently discharged patients, in compliance with HEDIS/Stars requirements. Perform comprehensive assessments, medication reconciliation, and care plan development. Identify patients with worsening or high-risk conditions (e.g., Stage D heart failure) and escalate care as appropriate. Collaborate with PCPs and Patient Navigators to ensure timely follow-up and continuity of care. Care Coordination Support smooth transitions from hospital to home by addressing patient needs within the critical 7-14 day post-discharge window. Partner with Patient Navigators to track discharges, schedule visits, and follow up on patient cancellations or refusals. Provide patient education and reinforce self-management strategies to reduce readmissions. Quality & Performance Contribute to achievement of TCM-related performance goals, including HEDIS and Stars measures. Document all encounters accurately and promptly in the electronic health record (EHR) to ensure compliance and proper reporting. Participate in quality improvement initiatives designed to enhance patient engagement and care outcomes. Team Collaboration Work closely with PCPs, Patient Navigators, and care teams across multiple practice locations (Essjay, Orchard Park, High St, and Transit Rd). Communicate effectively with interdisciplinary teams to ensure alignment on care plans and follow-up needs. Provide feedback on workflow optimization and assist in shaping best practices for centralized TCM.

Qualifications:

Licensed Nurse Practitioner (NP) or Physician Assistant (PA-C) in the state of New York (or state of practice) 2-3 years experience in primary care, hospital medicine, or transitional care preferred Buffalo Medical Group offers full medical benefits along with generous paid time off, bonus opportunities, 401K (with employer match), and a profit sharing pension, in addition to free parking and minimal travel, with offices located between Williamsville, Orchard Park and Buffalo. As an industry leader in customer service and cutting edge EMR technology, BMG was recognized as 2017 Healthcare Company of the Year, and believes in Treating People Well !

Job Type:

Full-time Pay:

$90,446.40 - $135,669.60 per year

Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Employee discount Health insurance Life insurance Paid time off Referral program Retirement plan Vision insurance

Experience:

Primary Care:

2 years (Preferred)

Transitional Care:

2 years (Preferred)

Hospital Medicine:

2 years (Preferred)

License/Certification:

PA or NP License (Preferred)

Work Location:

In person