Medical Director – PACE – Milford, DE

The PACE Your Life program, in Milford, Delaware, is seeking a Medical Director to assist in overseeing the program.

Position Summary:

The Medical Director provides general direction and supervision of the medical aspects of care of PACE participants. The Medical Director is responsible for the delivery and oversight of participant care, clinical outcomes, implementation and oversight of the quality improvement program, development and maintenance of medical policies and procedures/standards and protocols. The Medical Director will provide direction and supervision to primary care physicians, nurse practitioners, nursing staff and allied health professionals to ensure quality of care and consistent implementation of the PACE philosophy and model of care. The Medical Director serves as part of the leadership team of the PACE organization and represents the PACE program in the community

Essential Duties and Responsibilities:

Assume overall accountability and responsibility for the medical care of the participants. Oversee the medical service team to promote quality and outcome goals. Directs delivery of participant medical care.

Serves as the Primary Care Provider until census warrants hiring of additional providers.

Maintains responsibility for the implementation and oversight of the Quality Improvement (QI) activities and QI plan. Studies data, reviews procedures, identifies problems and makes necessary corrections to ensure the QI plan is viable and data has integrity.

Co-chairs the Quality Improvement 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 PACE.

Develops and maintains written objectives, policies and procedures, an organizational plan, and a quality improvement program for the medical service.

Coordinates and integrates medical services with other participant care services to provide a continuum of care for participants

In conjunction with the Quality Improvement Coordinator, develops, implements, and monitors outcome measurements to assure appropriate and efficient utilization of all health care services including:

Hospital inpatient and ER utilization

Pharmaceutical

Specialist referrals

Medication management

Nursing facility utilization

Ensures appropriate and optimal utilization of healthcare services by identifying and researching best practices and working with clinical staff and interdisciplinary team to make appropriate procedural, clinical, and/or operational decisions in the care of participants.

Supervises PACE primary care practitioners: physicians and nurse practitioners.

Provides back up and consultative support to PACE primary care providers in all settings

Conducts competencies for primary care staff.

Reviews medical records to evaluate care of participants and ensure that primary care practice is consistent with established protocols and practices.

Assists in developing and maintaining written job descriptions for the medical staff. Participates in the review of credentials and delineation of privileges of medical staff members, and assigns duties based upon education, training, competencies and job descriptions.

Participates in annual performance evaluations of Primary Care Physicians and Nurse Practitioners.

Consults with primary care staff and medical consultants to discuss clinical and case managementissues of PACE participants

Monitors clinic operations to assure integration of primary care and nursing services

Oversees and ensures appropriate diagnostic coding practices and documentation by Primary Care Providers.

Participates in primary care, hospital and nursing home rounds, and the 24-hour on-call system to assure continuity of care for PACE participants.

Acts as liaison with physician groups, specialists, and hospitals to represent PACE, provide education on the PACE model, ensure quality health care services, and assure good provider relationships and to generate referrals

Supervises and interfaces with any community PCPs who serve PACE participants.

Provides leadership to the interdisciplinary team, promoting the goals of the PACE model and those it serves.

Participates with the executive management group in internal operations, program development and resource utilization.

Participates in the National PACE Association physician network to assure representation and recognition.

When acting as Primary Care Physician, maintains daily attendance at and participates in interdisciplinary team meetings, communicating participant changes, collaborating on care planning decisions and coordinating 24-hour care delivery.

When acting as Primary Care Physician:

Provides primary care and assessment of participants in all settings

Evaluates and treat participants during acute illness.

Oversees and manage participants’ use of medical specialist and inpatient care

Admits participant to the hospital,

Provides primary care or coordination of care with hospitalists,

Provides updates to interdisciplinary team.

In conjunction with the interdisciplinary team, plans and coordinates discharge.

Participates in planning and budgeting and reviews financial and utilization reports

Complies with the required provisions of the PACE program’s Part D Fraud, Waste, and Abuse Compliance Program

Reports to the PACE Program Director

Qualifications:

Education/Credentials/ Licensure:

• MD or DO Degree and licensure to practice medicine in the state of Delaware. Board certified in internal medicine or family practice. Board certified in geriatrics, preferred, or CAQ in geriatrics.

Experience:

• Minimum of five years experience in medical practice, specializing in geriatrics preferred. Two years experience as a Medical Director or similar administrative role. Experience working with an interdisciplinary team. Managed care experience preferred.

Special Training:

• Understanding of the PACE Model delivery of care, subscribes to Preventative Model of Care for the Elderly

Age of Patients rendered care:

• Adultand geriatric patients

Knowledge & Skills:

• Proven clinical and administrative leadership.
• Ability to understand the PACE Care medicalmanagement process.
• Ability to conduct analysis of data and outcomes and to develop systems and processes
• Understanding of detailed State and FederalRegulations that govern the PACE program.
• Basic understanding of automation and information technology management systems.
• Proficient in Microsoft Word, Outlook, Excel and PowerPoint.
• Knowledgeable and proficient on the use of EMRs and ability to document appropriately all care planning, assessments, and progress notes.
• Ability to coordinate and collaborate with others in a team environment.
• Ability to act as an advocate for the frailelderly.
• Able to provide and encourage excellent customerservice to participants
• Able to perform at high level of autonomy for clinical and management decisions

Essential Physical Demands:

Physical, Psychological and ergonomic requirements:

• Successful performance of essential functions can best be achieved through consistent application of current knowledge, use of good judgment, common sense, ability to establish and carry outpriorities, effective use of interpersonal skills and ongoing communication with supervisor, departments, organizational committees,participants, families, community groups and vendors.
• Essential functions are carried out in a variety of positions including standing and sitting. To meet project management requirements all positions, require the ability to move freely throughout the network of facilities. Stooping, bending, lifting and carrying, as well as otherphysical demands, may be required as described below.
• Mentaldemands of this position can be high, with varied care needs ofparticipants in the management of frail seniors in a community setting.

We look forward to reviewing your resume.