Job Description

Classification Description:

UCSF physician assistants (PAs) are advanced practice providers (APPs) who possess the education, national board certification, California licensure, knowledge, clinical skills, and experience necessary to provide evidence-based patient care in their area of clinical practice. They provide routine, acute, critical, and specialty care as defined by their granted privileges/standardized procedures. These may include performing non-invasive or invasive procedures and operative first assist.

UCSF PAs are guided by and follow California regulations and the UCSF Medical Staff Bylaws, Rules and Regulations, and Policies*. They are authorized to exercise those privileges specifically granted to them by the Committee on Interdisciplinary Practice (CIDP), Executive Medical Board (EMB), and Governance Advisory Council (GAC),* and are expected to provide clinically indicated care that meets the applicable standard of care.

*UCSF-hired APPs whose UCSF clinical responsibilities require patient care at facilities/locations outside of UCSF Medical Center and Clinics must abide by California regulations and are expected to provide clinically indicated care that meets the applicable standards of care. Additionally, they must be credentialed and privileged and follow the Bylaws, Rules and Regulations, and Policies of those facilities/locations. Examples include but are not limited to Langley Porter Psychiatric Hospital (LPPH), Marin Health, UCSF Benioff Children's Hospital Oakland, UCSF Health Saint Francis & St. Mary's Hospitals and Clinics, Washington Hospital, and Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG).

All UCSF Health APP Positions:

Credentialing, privileging, and applying for health plan enrollment must be completed prior to the first working day.

UCSF Health requires all APPs working at UCSF Medical Center and Clinics** to be credentialed through the Office of Medical Affairs and Governance (OMAG) and privileged through CIDP, EMB, and GAC. This applies to APPs in inpatient and outpatient clinical settings at all UCSF Health facilities/locations. Procedure privileges are granted after the APP has demonstrated competency through the focused professional practice evaluation (FPPE) process and submitted activity logs via the UC Me e-Log.

Inability to comply with the requirements of OMAG/CIDP at all times will result in a leave of absence or suspension of privileges.

**UCSF-hired APPs whose UCSF clinical responsibilities require patient care at facilities/locations outside of UCSF Medical Center and Clinics must complete and maintain the credentialing and privileging requirements of those facilities/locations or will be placed on a leave of absence or have privileges suspended.

APPs are expected to be familiar with the productivity metrics in their clinical practice based on the essential responsibilities (phenotypes) below.

UCSF APPs are expected to demonstrate accountability for their own clinical practice, participate in patient and staff education, serve as resources for APPs, APP students/fellows, physician residents/fellows, nurses and other staff, exhibit leadership skills, and engage in the mentoring of newly hired APPs.

Department Specific Job Scope (for posting):

Complete this section with details about your department and the position responsibilities. This section will be used in the posting to attract providers to the position. Do not copy language from the classification description above.

The Interventional Radiology (IR) Physician Assistant is a highly skilled professional clinician who provides expert procedural and clinical care throughout the interventional radiology (IR) patient experience, including pre-procedural evaluation, intra-procedural support, and post-procedural management. The AHP practices in close collaboration with the interventional radiology attending physicians and interdisciplinary care team to promote excellent patient care across inpatient and outpatient settings.

This position requires flexibility for the APP to work at all UCSF Health facilities/locations

Key responsibilities for this role include (but not limited to) the following:

• Billable inpatient evaluation and management (E&M) services including evaluation of new adult and pediatric inpatient consults, daily rounding on established IR patients, assistance with admission and discharge for primary IR patients and with care coordination for all IR patients across all UCSF campuses.
• Comprehensive pre-procedural evaluation and preparation of adult and pediatric patients undergoing IR procedures: obtain and document relevant history, perform physical examinations, review diagnostic data, and identify patient-specific risks or barriers to care.
• Develop and implement peri-procedural plans of care in collaboration with the interventional radiology attendings
• Provide sterile first-assist support in IR suites and independently perform select low-complexity procedures for adult and pediatric patients within the approved scope of practice, training and competency.
• Manage post-procedural recovery, follow-up, patient education, and care coordination.
• Communicate with referring teams, consulting services, nursing staff, technologists, and other interdisciplinary team members to facilitate timely and effective care.
• Participate in outpatient clinical management including outpatient IR clinic, daily triage for add-on cases, consultations, and longitudinal follow up as needed.
• Document care accurately and thoroughly in the medical record in accordance with institutional, regulatory, and billing requirements.
• Contribute to quality improvement, workflow optimization, patient access, and program development within the IR service.

Clinical and Evaluation & Management Responsibilities

• Perform in-person evaluation of new inpatient IR consults.
• Conduct daily bedside rounding on established IR inpatients.
• Develop and document assessment and plan of care in collaboration with IR attendings.
• Communicate recommendations to referring teams and coordinate next steps.
• Document and bill E&M encounters in accordance with coding guidelines.

Care Coordination

• Coordinate procedures, imaging, labs, anticoagulation management, and peri-procedural planning.
• Serve as point of contact for inpatient teams regarding IR-managed patients. Support consult-to-procedure workflow optimization

Procedure Assistance

• Provide sterile first-assist support in IR suites and independently perform select low-complexity procedures for adult patients within the approved scope of practice, training and competency.

Quality, Safety & Professional Practice

• Participate in OPPE/FPPE, onboarding, and ongoing competency validation.
• Contribute to quality improvement initiatives related to access, throughput, and LOS

Responsibilities

Inpatient - Direct Patient Care (may include some or all of the responsibilities listed)

50%

1. Independently (independent APP encounter) or collaboratively (shared physician and APP encounter) evaluates and manages patients.
2. Includes taking histories, performing physical examinations, responding to changes in patient status, performing consults, ordering or furnishing medications/diagnostic tests/treatments/therapies/consultations/referrals/durable medical equipment (DME)/home health services.
3. Care provided must be documented in the electronic medical record in accordance with the UCSF Rules and Regulations.
4. Provider services must be billed to reflect the performing provider and comply with the APP Billing Policy 3.08.01.
5. APPs must respond to clinical documentation integrity inquiries from the Department of Quality and Patient Safety within 3 days.

1.2. Performs procedures granted to them via privileges/standardized procedures.

1.3. Identifies patients with acute decompensation or failure and responds to the hospital plan of care and reviews with physician.

1.4. Initiates consultations as indicated.

1.5. Documents independent assessment findings and recommends appropriate treatments.

1.6. Participates in service rounds and patient evaluation and treatment planning.

1.7. Reviews lab tests, x-rays, and other diagnostic tests, and initiates appropriate team plans.

1.8. Evaluates complex cases, establishes individualized plans of care for disposition to a lower level of care.

1.9. Interprets and acts upon completed tests, procedures, and radiographic studies.

1.10. Completes clinically relevant paperwork/electronic health record (EHR) documentation, including but not limited to ordering medications, completing episodic care notes and discharge summaries in accordance with the UCSF Rules and Regulations.

1.11. Effectively communicates findings, treatment options, and care plans with patients and their families

1.12. May first assist in the operating room if privileged to do so through OMAG after completing the required certification and proctoring.

1.13. Monitors and evaluates patients for discharge. Sets parameters and guidelines for continuum of care with multi-disciplinary team. This includes evaluating and defining discharge regimen.

1.14. 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 (may include some or all of the responsibilities listed)

10%

1.1. Coordinates care throughout the continuum including hospital admission, care coordination with staff and consulting services, and hospital discharge planning.
1.2. Coordinates episodic care and determines timing of routine clinic follow up.
1.3. Participates in huddles with clinic/hospital staff and anticipates patients who require close management or intervention.
1.4. Consults with nursing staff on plan and implementation of individualized nursing care plans.

1.5. Independently provides case summaries for disability, insurance agencies, workers compensation, work releases, and medical supply agencies.
1.6. Formulates and implements protocols to improve quality and efficiency and control waste in the clinical specialty.

Outpatient - Independent Encounters (may include some or all of the responsibilities listed)

20%

1. Evaluates and manages patients in independent APP encounters, including telehealth.
2. Includes providing care to new, follow-up, acute, routine, and specialty patients.
3. 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/durable medical equipment (DME)/home health services.
4. Reviews or collaborates with attending physician as needed.
5. Care provided must be documented in the electronic medical record in accordance with the UCSF Rules and Regulations.
6. Provider services must be billed to reflect the performing provider and comply with the APP Billing Policy 3.08.01.

1.2. Performs procedures individually granted to them via standardized procedures/privileges.
1.3. Identifies high-risk groups and complex cases for review with attending physician. Initiates consultations as appropriate.

1.4. Evaluates complex cases, establishes individualized plans of care for rehabilitation, and facilitates occupational and physical therapy and physical medicine and rehabilitation consultations.
1.5. Interprets and acts upon the ordered tests, procedures, and radiographic studies in a timely fashion.

1.6. 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) (may include some or all of the responsibilities listed)

10%

1. Evaluates and manages patients in shared encounters with attending physician, including telehealth.
2. This should increase clinic access with a goal of doubling clinic volume since two providers will be sharing the clinic responsibilities.
3. Includes providing care to new, follow-up, acute, routine, and specialty patients.
4. 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/durable medical equipment (DME)/home health services.
5. Care provided must be documented in the electronic medical record in accordance with the UCSF Rules and Regulations
6. Provider services must be billed to reflect the performing provider and comply with the APP Billing Policy 3.08.01.
   
   1. May first-assist in the operating room if privileged to do so through OMAG after completing the required certification and proctoring.

1.3. Identifies high-risk groups and complex cases for review with attending physician. Initiates consultations as appropriate.

1.4. Evaluates complex cases, establishes individualized plans of care for rehabilitation, and facilitates occupational and physical therapy and physical medicine and rehabilitation consultations.
1.5. Interprets and acts upon the ordered tests, procedures, and radiographic studies in a timely fashion.

1.6. Completes clinically relevant paperwork/EHR, including but not limited to ordering medications, completing episodic care notes and telephone encounters.

Outpatient - Care Coordination (may include some or all of the responsibilities listed)

10%

1.1. 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.
1.2. Management of the EHR, including patient and staff messages and other inbasket tasks.

1.3. Coordinates episodic care and determines timing of routine clinic follow up.
1.4. Participates in huddles with clinic/hospital staff and anticipates patients who require close ma