Chief Medical Officer

5 days ago

Riverside, United States PACE Organization of Rhode Island Full time
Job Summary

The Chief Medical Officer provides medical direction and supervision of the medical aspects of care for PACE-RI. This includes general medical direction, supervision of related primary care, nursing, and allied health services, and authority over the quality improvement program.

Key Responsibilities
  • Assumes overall accountability and responsibility for the medical care of participants.
  • Provides direct primary care for an appropriate panel size of participants.
  • Performs comprehensive history and physical on new enrollees within 30 days of enrollment.
  • Evaluates and treats participants with episodic illnesses and informs IDT as to the chronic and acute care trajectory.
  • Judiciously utilizes and oversees the use of specialist consultations as needed.
  • Admits participants to hospital, providing primary care attending responsibilities; and/or coordinates and manages care through pro-active collaboration with hospitalist, provides updates to the IDT on a regular basis, and assists with actively coordinating discharge planning with IDT.
  • Manages all care of participants in the nursing home, conducts regular visits, and performs telephone consultations with nursing home staff as required.
  • Collaborates with other IDT members and other providers to formulate and achieve care plan goals, meet emergent and acute needs of participants, and assure comprehensive and continuous care.
  • Ability to work sensitively and effectively with individuals of diverse and ethnic cultural backgrounds.
  • Actively participates in family conferences and manages sensitive conversations related to medical care needs.
  • Manages the placement of clients in the hospital, skilled nursing facility and long-term care placement by participating in the approval, review and management of such placements.
  • Maintains positive relationship with hospitals and agencies that support community-based long-term care.
  • Ensures development and compliance with organizational policies and procedures and all applicable regulatory requirements and standards.
  • Develops written policies, protocols, and or staff education designed to improve the quality of clinical care.
  • Serves as an active member of committees that require input regarding medical care or assigns an appropriate designee.
  • Provides medical evaluation, direction and guidance to PACE as required by law and consistent with CMS regulations.
  • Furnishes medical expertise, leadership and consultation regarding the design, implementation, and evaluation of clinical services within the context of organizational mission, vision and goals.
  • Collaborates with senior management to promote quality, efficiency and effectiveness of service. This includes responsibility for use of current clinical services, and the design of new services to reduce institutional utilization.
  • Recognizes trends in care provision/utilization and oversees appropriate utilization of medical and institutional services. Identifies negative trends and coordinates appropriate interventions that along with IDT will trigger a plan to manage them in a timely manner; develops quality calendar with Quality Specialist and reports out on results annually to Board of Directors.
  • Recruits and provides ongoing supervision, mentorship and training of primary care physicians and nurse practitioners and provides clinical oversight and input into their periodic performance evaluations.
  • Creates and encourages the implementation of pathways or tools that assist the team in making sound clinical decisions regarding utilization of services.
  • Oversees the training of medical students, fellows, and research projects at or in conjunction with PACE-RI.
  • Demonstrates thorough knowledge of current concepts, evidenced based practice, theories, and practices to guide the clinicians and IDT in home and community-based care for the elderly and disabled adults.
  • Participates in the contract negotiations for the medical-related providers and evaluates the competence and quality of existing providers on a regular basis.
  • Serves as community liaison with physicians, hospitals, and other health care providers.
  • Interfaces actively with other PACE-RI physicians and medical directors.
  • Together with Senior Management, supports the IDT in reaching decisions via consensus according to PACE-RI policy and procedural guidelines.
  • Create and implement departmental audit system to identify areas of non-compliance and opportunities for quality improvement; use data to inform decision making and action steps.
  • Responsible for leading and managing the strategic and operational aspects of pharmacy services, ensuring compliance with regulatory standards, and driving improvements in medication safety, quality, and efficiency.
  • Demonstrates an understanding of the importance of clear, thorough documentation as crucial to good participant care; completes and enters accurate, thorough participant documentation in the electronic health record; enters documentation for assessments, orders, and notes within required timeframes.
  • Performs other related duties as required and assigned.

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