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Medical Director
2 months ago
About myPlace Health
myPlace Health is a mission-driven healthcare organization dedicated to providing value-based, comprehensive care and coverage for older adults with significant needs. Our goal is to enable seniors to live the independent lives they deserve.
We specialize in delivering seamless primary care, integrated health plan coverage, personalized social engagement, and customized services to our participants in their preferred place. Our PACE model is designed to provide high-quality care and support to vulnerable older adults and frail seniors.
Job Summary
We are seeking an experienced Medical Director to lead our clinical operations and oversee the delivery of high-quality care to our participants. The ideal candidate will have a passion for serving high-risk seniors and frail older adults, and will thrive in a fast-paced environment with a collaborative, team-based approach.
Key Responsibilities
- Clinical Care and Oversight
- Ensure that evidence-based high-quality, cost-effective care is provided to PACE program participants in accordance with the PACE program mission, current standards of medical practice, and applicable regulatory requirements.
- Provide medical care to PACE participants, including the evaluation, diagnosis, and management of their medical conditions, including but not limited to taking medical history, performing biannual examinations, ordering and interpretation of diagnostic tests, formulating treatment plans, writing prescriptions, ongoing follow-up of same, and management of medical information from specialists and hospital teams.
- Document medical care in the participant's medical record, in compliance with PACE documentation policies.
- Recruitment, training, supervision, and evaluation of employed physicians, advanced practitioners, and transitions of care coordinators
- Training and oversight of contracted primary care physicians and advanced practitioners as well as contracted specialists
- Quality and Utilization Management and Oversight
- Oversee the development and implementation of the Quality Improvement and Performance Improvement Program (QAPI) in collaboration with other key leaders and staff assigned to the market.
- Monitor utilization management trends, such as inpatient hospitalization and emergency room visits and set outcome targets.
- Develop interventions to support the optimum health of participants including functional and quality of life, participant, and caregiver satisfaction through the efficient use of program resources and achievement of program goals.
- Ensure the completion of periodic chart audits for the purpose of monitoring in the areas of quality of care, compliance with PACE regulations, utilization plans, appropriate use of medications and identifying areas of risk.
- Ensure adequate primary care provider resources are available for staff to meet participant needs and regulatory requirements.
- Oversee provider after-hours on-call arrangements to ensure 24-hour provider availability with consideration of participant and provider satisfaction.
- Provide consultation and support for program staff regarding grievances, appeals and IDT decision-making processes; evaluate medical-related grievances that arise (unless a conflict of Interest exists)
- Stay abreast of current literature and best practices and make recommendations to adjust policies and procedures as appropriate.
- Monitor the quality of care provided by key contracted providers such as hospitals, SNFs, and long-term care facilities.
- Develop collaborative relationships with community physicians and other providers to promote positive, effective working relationships and prospect referrals.
- Promote collaboration, accountability and continuing professional development of PACE primary care staff via regular group meetings, one-on-one sessions, and other strategies.
- Participate in the Quality committee and other committees or workgroups as needed.
Requirements
- MD or DO required; active board certification in geriatrics, complex care, home-based care, palliative care, internal medicine, or other related clinical area (with continued certification throughout employment)
- Previous experience in a PACE model or similar environments
- Five or more years' practice of medicine with a minimum of two years working with an elderly or frail population.
- Current, unrestricted medical license in the states in which we operate.
- Current DEA certificate
- Up-to-date immunization records
- Bilingual preferred (English and Spanish)
Location
- Los Angeles, CA
- Ability to be 100% physically present at our clinic, in the community, or in our participants' homes as needed
- Relocation benefits offered if willing to reside in Los Angeles
