Physician Assistant, Sr.

Job Description

The Critical Care Physician Assistant is a licensed physician assistant who possesses advanced education, knowledge, clinical skills and experience necessary to provide expert advanced practice in critical care. The primary responsibility of the CCPA is providing and directing care for patients in the adult ICUs at the UCSF Medical Center. The CCPA is responsible for maintaining quality of care standards for all procedures and clinical care provided in the ICUs, and provides self‑direction and accountability in the development of this role within the medical center. The CCPA shall provide medical care under the supervision of the Physician Director of Adult Critical Care Medicine and collaborate with physicians, fellows, and residents. The CCPA may rotate through all focused care ICUs—including cardiothoracic, neurologic, neurosurgical, medical, general surgical, and transplant units—and will work collaboratively with physician students and attendings. This position is scheduled for 12‑hour rotating shifts from days to nights, including holidays and weekends.

Responsibilities

Inpatient – Direct Patient Care (60%)

• Independently (independent APP encounter) or collaboratively (shared physician and APP encounter) evaluates and manages patients.
• Includes taking histories, performing physical examinations, responding to changes in patient status, performing consults, ordering or furnishing medications/diagnostic tests/treatments/therapies/consultations/referrals/DME/home health services.
• Care provided must be documented in the electronic medical record in accordance with the UCSF Rules and Regulations.
• Provider services must be billed to reflect the performing provider and comply with the APP Billing Policy 3.08.01.
• APPs must respond to clinical documentation integrity inquiries from the Department of Quality and Patient Safety within 3 days.
• Performs procedures granted to them via privileges/standardized procedures.
• Identifies patients with acute decompensation or failure and responds to the hospital plan of care and reviews with physician.
• Initiates consultations as indicated.
• Documents independent assessment findings and recommends appropriate treatments.
• Participates in service rounds and patient evaluation and treatment planning.
• Reviews lab tests, x‑rays, and other diagnostic tests, and initiates appropriate team plans.
• Evaluates complex cases, establishes individualized plans of care for disposition to a lower level of care.
• Interprets and acts upon completed tests, procedures, and radiographic studies.
• Completes clinically relevant paperwork/EHR documentation, including but not limited to ordering medications, completing episodic care notes and discharge summaries in accordance with UCSF Rules and Regulations.
• Effectively communicates findings, treatment options, and care plans with patients and their families.
• May first assist in the operating room if privileged through OMAG after completing required certification and proctoring.
• Monitors and evaluates patients for discharge. Sets parameters and guidelines for continuum of care with multidisciplinary team. This includes evaluating and defining discharge regimen.
• Discharges patients including prescribing/furnishing medications, ordering DME, and recommending or referring for ongoing follow‑up care, providing discharge teaching, and completing discharge summaries.

Inpatient – Care Coordination (40%)

• Coordinates care throughout the continuum including hospital admission, care coordination with staff and consulting services, and hospital discharge planning.
• Coordinates episodic care and determines timing of routine clinic follow‑up.
• Participates in huddles with clinic/hospital staff and anticipates patients who require close management or intervention.
• Consults with nursing staff on plan and implementation of individualized nursing care plans.
• Independently provides case summaries for disability, insurance agencies, workers compensation, work releases, and medical supply agencies.
• Formulates and implements protocols to improve quality and efficiency and control waste in the clinical specialty.

Outpatient – Independent Encounters

• Evaluates and manages patients in independent APP encounters, including telehealth.
• Includes providing care to new, follow‑up, acute, routine, and specialty patients.
• Includes taking histories, performing physical examinations, interpreting diagnostic tests, formulating evidence‑based assessments and plans, responding to changes in patient status, and ordering medications/diagnostic tests/treatments/therapies/consultations/referrals/DME/home health services.
• Reviews or collaborates with attending physician as needed.
• Care provided must be documented in the electronic medical record in accordance with UCSF Rules and Regulations.
• Provider services must be billed to reflect the performing provider and comply with the APP Billing Policy 3.08.01.
• Performs procedures individually granted to them via standardized procedures/privileges.
• Identifies high‑risk groups and complex cases for review with attending physician. Initiates consultations as appropriate.
• Evaluates complex cases, establishes individualized plans of care for rehabilitation, and facilitates occupational and physical therapy and physical medicine and rehabilitation consultations.
• Interprets and acts upon the ordered tests, procedures, and radiographic studies in a timely fashion.
• Completes clinically relevant paperwork/EHR, including but not limited to ordering medications, completing episodic care notes and telephone encounters.

Outpatient – Shared Encounters with Physician(s)

• Evaluates and manages patients in shared encounters with attending physician, including telehealth.
• This should increase clinic access with a goal of doubling clinic volume since two providers will be sharing the clinic responsibilities.
• Includes providing care to new, follow‑up, acute, routine, and specialty patients.
• Includes taking histories, performing physical examinations, interpreting diagnostic tests, collaborating on evidence‑based assessments and plans, responding to changes in patient status, and ordering medications/diagnostic tests/treatments/therapies/consultations/referrals/DME/home health services.
• Care provided must be documented in the electronic medical record in accordance with UCSF Rules and Regulations.
• Provider services must be billed to reflect the performing provider and comply with the APP Billing Policy 3.08.01.
• May first‑assist in the operating room if privileged through OMAG after completing required certification and proctoring.
• Identifies high‑risk groups and complex cases for review with attending physician. Initiates consultations as appropriate.
• Evaluates complex cases, establishes individualized plans of care for rehabilitation, and facilitates occupational and physical therapy and physical medicine and rehabilitation consultations.
• Interprets and acts upon the ordered tests, procedures, and radiographic studies in a timely fashion.
• Completes clinically relevant paperwork/EHR, including but not limited to ordering medications, completing episodic care notes and telephone encounters.

Outpatient – Care Coordination

• Coordinates care throughout the continuum including hospital admission, care coordination with staff and consulting services, and hospital discharge planning. (Does not include management of inpatients.)
• Management of the EHR, including patient and staff messages and other inbox tasks.
• Coordinates episodic care and determines timing of routine clinic follow‑up.
• Participates in huddles with clinic/hospital staff and anticipates patients who require close management or intervention.
• Attends department quality improvement meetings and participates in patient evaluation and planning.
• Consults with nursing staff on plan and implementation of individualized nursing care plans.
• Independently provides case summaries for disability, insurance agencies, workers compensation, work releases, and medical supply agencies.

Qualifications

• Graduation from a PA Program accredited by the Accreditation Review Commission on Education for the PA (ARC‑PA).
• A minimum of one year of PA experience in adult critical care medicine or completion of an accredited APP fellowship incorporating critical care.

Preferred Qualifications

• Completion of an accredited critical care practice transition program.
• A minimum of 2 years of recent experience as an inpatient Physician Assistant in an academic medical center.

License/Certifications

• California Physician Assistant (PA) License without restriction.
• National Board Certification from the National Commission on Certification of Physician Assistants (NCCPA).
• California Driver License (if required for position).
• Drug Enforcement Administration (DEA) Registration with Schedules 2, 2N, 3, 3N, 4 and 5 registered to a California address.
• American Heart Association (AHA) Basic Life Support (BLS) certification.
• American Heart Association Advanced Life Support (ALSC) certification.
• Emergency Neurological Life Support (ENLS) certification.

Salary Information

The final salary and offer components are subject to additional approvals based on UC policy. Your placement within the salary range is dependent on a number of factors including your work experience and internal equity within this position classification at UCSF. For positions that are represented by a labor union, placement within the salary range will be guided by the rules in the collective bargaining agreement. To learn more about the benefits of working at UCSF, including total compensation, please visit

Equal Employment Opportunity

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.

About The Team

The Critical Care Advanced Practice Provider (CC APP) team at UCSF provides expert care in the adult intensive care units. The CC APPs are an element of the interdisciplinary critical care team that includes attending physicians, physicians in training, pharmacists, registered nurses, rehabilitation therapists, and UCSF students. They provide care in all adult ICUs including Cardiac, Neurologic, Medical, and Surgical units. The team collaborates with the UCSF School of Nursing and supports the UCSF Surgical and Critical Care Advanced Practice Provider Fellowship. The CC APP group is active in various quality improvement, cost reduction, and professional development projects.