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Medical Director

Company: Commonwealth Care Alliance
Location: Springfield
Posted on: May 16, 2020

Job Description:

MEDICAL DIRECTOR

Job ID

2020-2914

Category

Clinical (Office Based)

Type

Regular Full-Time

Actual Work Location

101 Wason, Springfield, MA

WHY THIS ROLE IS IMPORTANT TO US

The Clinical Group, Springfield Medical Director provides clinical oversight and leadership as well as direct care to CCA s members with complex physical, behavioral health and social needs.
This position is responsible for providing medical oversight to CCA s Senior Care Options program, with particular focus on engagement with network primary care providers and CCA clinicians to ensure the successful achievement of key programmatic and quality objectives. At Clinical Group East, this position will be responsible for partnering with the Clinical Director to lead the development of clinical practice guidelines, ensure appropriate clinical supervision of advanced practice clinicians, spearhead clinical quality and performance improvement initiatives, clinical risk management, achieve practice-level and individual patient quality outcomes, and support clinical best practice adoption with specific focus on providing appropriate care to frail elderly patients and furthering the integration of behavioral health and primary care services.

The direct patient care component to this role involves providing clinical supervision to home-visiting nurse practitioners, physician assistants and nurses managing members with complex physical, cognitive and behavioral health needs, as part of an interdisciplinary team. This includes performing joint home visits with CCA clinicians, performing annual physical exams on long-term SNF members, engaging with primary care and specialist physicians in care plan development, regular consultation and case review, and occasionally assuming full primary care provider responsibilities for members with complex needs. Additionally, the Medical Director will participate in out-of-hours on-call duties as well as being available to telephonically to triage calls and discuss cases with other clinicians on the care team.

WHAT YOU\'LL BE DOING

* Interface with PCPs, specialists, and hospitals to promote an understanding of CCA s unique model, facilitate collaboration and shared decision-making

* Clinical oversight and supervision for advance practice clinicians delivering augmented primary care and care management to CCA members

* Monitoring, evaluation, and quality improvement activities

* Active participation in CCA s Ethics Committee, Quality and Value Management Committee, Clinical Leadership Group, and the MD Group

* Program development and integration of clinical innovations, including inpatient services, community paramedicine, care transitions, LifeChoices palliative care program, and others

* Development of educational content around complex care delivery, geriatrics and palliative care tailored to CCA / CCC clinicians

* Medical necessity reviews for acute (inpatient vs observation) level of care, as well as for service authorization requests

* Engagement with CCA s acute and post-acute care team to improve quality of care and enhance relationships with SNFs and hospitals caring for CCA members

* Second level review of member appeals and quality of care concerns

* Quarterly review of CCA s pharmacy trends and engagement in the annual formulary build, with specific focus on medications of particular relevance to the geriatrics population

* Functions as clinical oversight for CCA Clinical Group clinicians. Is available Monday Friday 8 a.m. 6 p.m.
to provide clinical support for Advanced Practice Clinicians and RNs. * Documents all clinical work in a timely manner and provides the necessary documentation required for data collection and billing purposes.

* Participates in all call responsibilities.

* Participates in Doctor of the Day responsibilities.

* Attends clinical team meetings and other mandatory educational sessions.

* Conducts educational and training activities that promote appropriate and effective patient care

* Participates in the planning, implementation and coordination of health education and counseling of the patient and family. Teaches families and caretakers how to provide safe, effective care and promote optimum function for patients at home. Documents the level of understanding and response to teaching.

* Provides educational updates to clinical staff.

* Participates in orienting and training new employees as required.

* Participates in quality assessment and quality improvement within CCA as a whole

* Seeks to maintain a constructive work environment and maintains effective communication with other employees and managers

* Provides clinical oversight and supervision of NP/PA staff

* Communicates with primary care teams and coordinates post-acute follow up as needed

* Participates in case review and quality improvement projects

* Participates in annual clinical team retreats and social / teambuilding events

* Maintains required professional credentialing and appropriate CME standards

* Attends external meetings and activities as a representative of the organization as requested

Secondary Responsibilities

* Plans and directs medical policies and programs

* Responsible for strategic clinical relationships with physicians

* Oversees the development of the clinical content in marketing materials

* Ensures clinical programs are in compliance Writes research publications to support clinical service offerings

WHAT WE\'RE LOOKING FOR

* MD, PhD, Law Degree or equivalent doctoral degre

* MD or DO degree from an Accredited institution

* Board Certified or Board Eligible in Family Practice or Internal Medicine with specialty in geriatrics

* Interest and experience in serving underserved and disability populations is essential

* Experience with quality improvement, monitoring and evaluation, health systems strengthening, innovation and training is desired, although not essential

* Additional post-fellowship work experience as a geriatrician in low-resource/community health center

* PACE or SCO program is desired

* Demonstrated commitment to and interest in palliative care principles

* Proven skills, knowledge base and judgment necessary for independent clinical decision-making

* Excellent organizational, time-management and problem-solving skills

* Ability to function effectively as part of a multi-disciplinary team

* Effective oral and written skills

* Strong interpersonal skills

* Commitment to social justice in medicine and an understanding of healthcare reform

* Effective teaching and mentorship skills

* Familiar with a variety of the field's concepts, practices, and procedures

* Relies on extensive experience and judgment to plan and accomplish goals

* Performs a variety of complex tasks

* Leads and directs the work of others

* A wide degree of creativity and latitude is required

* English, bilingual preferred

Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.

Keywords: Commonwealth Care Alliance, Springfield , Medical Director, Executive , Springfield, Massachusetts

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