Company: Inspira Medical Centers
Posted on: September 21, 2022
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
- 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
- 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
- Monitors and assures the appropriateness of utilization of
medical services including:
- Hospital inpatient and ER utilization
- 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
- Provides supervision of primary care practitioners.
- Recruits and trains primary care physicians and nurse
- 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
- 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
- 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
- Develops and ensures that appropriate medical staffing patterns
- 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
- 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
- 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
- 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
- Participates in staff orientation and staff education
- Participates in continuing education and training of all LIFE
- Participates in the National PACE Association Primary Care and
Medical Director network to assure networking and communication
regarding best practices and facility representation and
- 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
- Participates in planning and budgeting for the Medical
- 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
- 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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