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Company: Inspira Medical Centers
Location: Vineland
Posted on: September 21, 2022

Job Description:

OUR MISSION: Our mission is to provide high quality health services that improve the lives of all we serve. MAJOR FUNCTION: Provides general medical direction and supervision of the medical aspects of care for LIFE Program from both provider and payor perspectives. Responsible for the delivery of participant care and clinical outcomes. Responsible for implementation and oversight of the quality assessment and performance improvement program. Collaborates with Director of Quality for all Quality activities. Assures effective utilization management. Responsible for the development and maintenance of medical policies and procedures/standards and protocols. Provides direction and supervision to Inspira LIFE primary care team. Identifies appropriate providers for contracted provider network and collaborates with Executive Director, Director of Finance, and others to facilitate and maintain the contractual relationship. Serves as mentor and preceptor for medical residents and other, health care team interns and students. Serves as member of Inspira LIFE Executive Leadership Team. Provides some direct patient care as a member of the primary care team. QUALIFICATIONS: A. Education: Medical Doctorate Degree: MD or DO B. Experience: Minimum of 2 years working with the frail or elderly; At least 1 year in a leadership position; prior experience with a capitated care model and/or in utilization management highly preferred. Successful practice in an interdisciplinary model preferred. C. Certification/Licensure: Valid Drivers license, proof of insurance and have a reliable means of transportation as described in Fleet Policy # TR 118.D. Physical Requirements: Employees must have medical clearance for communicable disease and up to date immunizations before having direct participant contact. Requires corrected vision and hearing to normal range. Must be able to communicate verbally with all staff, vendors, and clients. Requires manual and finger dexterity and eye-hand coordination; the ability to use department equipment. The conditions described here are representative of those that must be met by a staff member to successfully perform the essential functions of the job:

  • Serves as lead and collaborating physician for the primary care providers.
  • Assumes overall accountability and responsibility for the medical care of the participants of the LIFE Program. Oversees the medical service team to promote quality and outcome goals. Directs delivery of participant medical care.
  • Has overall responsibility for the implementation and oversight of the Quality Improvement activities, and QI plan. Collaborates with Director of Quality to study data, review procedures, identify problems and make necessary corrections to ensure the QAPI plan is viable and data has integrity.
  • Active Member of the Quality Assurance Committee.
  • Provides medical oversight in the development of standards and uniform treatment policies and procedures to assure they are inclusive of the knowledge and values which guide the LIFE program.
  • Develops and maintains written objectives, policies and procedures manual, an organizational plan, and a quality assurance program for the medical service. All medical policies shall be reviewed at least annually.
  • Develops, implements, and monitors outcomes measurements to assure appropriateness and usefulness for the LIFE program. Identifies key clinical processes in ongoing services
  • Coordinates and integrates the medical services with other participant care services to provide a continuum of care for the participants.
  • Monitors and assures the appropriateness of utilization of medical services including:
  • Hospital inpatient and ER utilization
  • Pharmaceuticals
  • Specialist referrals
  • Medication management
  • Nursing facility utilization
  • When problems are identified he/she researches best practices and works with clinical staff and interdisciplinary team to make appropriate procedural and or operational changes to avoid unnecessary hospitalizations and improve the health of participants
  • Provides supervision of primary care practitioners.
  • Recruits and trains primary care physicians and nurse practitioners.
  • Assists in developing and maintains written job descriptions for the medical staff.
  • Participates in the review of credentials and delineation of privileges of medical staff members, and assigning duties based upon education, training, competencies and job descriptions.
  • Participates in performance evaluations and competency reviews of Nurse Practitioners and Primary Care Physicians.
  • Consults with primary care staff to discuss clinical and case management issues.
  • Monitors the LIFE clinic operations to assure integration of primary care and nursing services.
  • Oversees and ensures appropriate diagnostic coding practices of Primary Care Providers.
  • Participates in primary care, maintains privileges at contracted nursing homes and presence at contracted assisted living facilities.
  • Responsibility for the 24-hour on-call process to assure continuity of care for LIFE participants. Maintains availability for consultation to the PCP on-call and obtains coverage for absences. Assures there is provider coverage for 24/7 operations.
  • Develops and ensures that appropriate medical staffing patterns are implemented.
  • Serves as community liaison with physician groups, specialists, and hospitals to represent the LIFE program and assures good provider relationships. Nurtures relationships with community physicians and provides education to assist opportunities for referrals from their practices.
  • Assures there is an adequate and appropriate provider network; Identifies appropriate providers for contracted provider network in conjunction with the Executive Director and participates in contract negotiations and monitoring with medical related providers.
  • Assures contracted providers are oriented to PACE and Inspira LIFE in compliance with regulation
  • Provides leadership with Medical Staff, promoting the goals and needs of the LIFE program and those it serves.
  • Assures Primary Care Staff assume accountability to fulfill their responsibilities as engaged, collaborative members of Interdisciplinary team
  • Provides medical liaison with other medical departments and divisions of the INSPIRA HEALTH system, communicating the values and unique aspects of LIFE so that the interactions may be relevant to, and supportive of, the activities of both LIFE and the INSPIRA HEALTH system.
  • Serves as member of Inspira LIFE Executive Leadership team to oversee internal operations, budget development and monitoring, program development, staff and participant orientation and resource utilization.
  • Participates in staff orientation and staff education activities.
  • Participates in continuing education and training of all LIFE staff.
  • Participates in the National PACE Association Primary Care and Medical Director network to assure networking and communication regarding best practices and facility representation and recognition.
  • Identifies opportunities for clinical and health care delivery research which will enhance the geriatric leadership role of the LIFE Program in clinical expertise and innovation.
  • When acting as Primary Care Physician functions as a member of the interdisciplinary team. Maintains daily attendance at and participates in interdisciplinary team meetings; communicates participant changes, collaborates on care planning decisions and coordination for 24-hour care delivery.
  • When acting as Primary Care Physician evaluates and treats participants during acute illness. Oversees and manages participants use of medical specialist and inpatient care. Coordinates participant admissions to the ER or the hospital as needed. Maintains admitting privileges at the hospitals for regulatory compliance. Provides primary care (attending) responsibilities for medical management; provides updates to Interdisciplinary Team in conjunction with the Interdisciplinary team plans and coordinates discharge.
  • Approves the contents, location and frequency of checking contents, including expiration dates, of emergency kits or carts, equipment, and supplies, and assigning responsibility for these checks.
  • Participates in planning and budgeting for the Medical Services.
  • Drives the Quality Assurance process and provides expert clinical program planning.
  • Assures effective communication with contracted providers and clarity among staff and participants about role of those consultants.
  • Promotes a high reliability organization to minimize the risk of harm to the participant and staff.

Keywords: Inspira Medical Centers, Vineland , MEDICAL DIRECTOR, Executive , Vineland, New Jersey

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