Hospice Medical Director

Hospice Medical Director

The role of the Hospice Medical Director (HMD) will serve as outlined in the Medicare Interpretive Guidelines and the Medicare Hospice Conditions of Participation (418.102). This individual has responsibility for the medical component of the hospice program and assures efficient and effective quality of care for the patients we serve. This includes the establishment and maintenance of medical standards/protocols and systems of monitoring accountability, a focus on the continual improvement of care access, care delivery, and ensuring compliance with applicable standards and regulations. The HMD participates routinely in certification, recertification, and decertification of terminal prognosis for hospice patients, including the necessary collaboration and documentation to support eligibility decisions. In addition, the HMD provides direct and indirect supervision of all hospice providers. The HMD works collaboratively with Chief Medical Officer and the Chief Clinical and Operations Officer to provide medical excellence. Clinical responsibilities will include seeing patients in the inpatient unit, or other care settings, as needed, and participating in daytime, after-hours, weekend, and holiday provider coverage, as needed.

Essential Duties & Responsibilities

• Work to achieve performance goals for self and for the Hospice Provider Team, pursue progress toward My Learning Plan (MLP) and demonstrate Four Seasons values and competencies
• Consistently deliver patient care in accordance with agency guidelines and state and federal regulations and standards
• Works with Leadership Team members and appropriate clinical directors to ensure quality patient care is delivered according to agency guidelines and state and federal regulations and standards
• Support the ongoing development and implementation of policies and procedures that guide and support clinical practice standards and the provision of medical staff services
• Demonstrate effective supervision for the hospice physicians/providers while providing standards for excellence for all service and support lines, including education and training of clinical providers in hospice eligibility, certification, and recertification, proper documentation, and billing
• Conduct providers documentation reviews eligibility, billing, and clinical care
• Serve as a resource to staff on clinical issues, current trends in hospice medicine, and state and federal regulations
• Represent the organization in a professional, competent manner in the community and consistently exhibit our Four Seasons' CBRIGHTER values for internal and external stakeholders.
• Serve as a member of Complex Case and Eligibility Reviews and oversee, direct, and support the rendering of medical management decisions that maximize benefits for patients and families while pursuing and supporting organizational objectives
• Provide guidance for the Care Access Team to ensure patient eligibility, related/unrelated medication review, and accurate and timely completion of the Hospice Addendum.
• Provide clinical summaries for ADRs and audits and participate in the appeals process (redetermination, reconsideration, Administrative Law Judge hearings) and/or adjudication
• Collaborate with Health Information Management (HIM) on the death certificate completion process and timely completion of outstanding orders.
• Represent the Agency on ad hoc committees as appropriate; interfaces with the provider community regarding medical review, utilization review, and quality assurance concerns
• Provide clinical care when needed, including any care setting; participate in on-call medical coverage for hospice patients on a rotational basis with other hospice providers
• Serve as collaborating physician for Hospice and Palliative Care Advance Practice Providers; number will be determined by organizational best practice in accordance with state regulations
• Participate in the accreditation and survey process
• Timely review and collaboration with Leadership Team and Quality/Compliance regarding service recoveries, occurrence reports, and sentinel events
• Represents Four Seasons in state, regional, and national forums, committees, etc. as available
• Maintain a working knowledge of applicable National, State, and local laws and regulations, TJC Medicare and Medicaid Programs: Hospice Conditions of Participation and Payment, and other regulatory requirements related to the medical and allied health staff
• Participate in leadership training and meetings, organizational initiatives such as performance improvement (PI), goal planning, and strategic planning
• Perform other but similar duties as assigned

Other Duties:

• Practice safety and infection control methods
• Assess clients for participation in research studies
• Complete annual and ad hoc mandatory education requirements

Knowledge, Skills, and Abilities:

• Knowledge of federal, state, and local regulations
• Knowledge of Medicare Conditions of Participation
• Excellent analytical skills
• Excellent oral/written skills
• Excellent interpersonal skills
• Excellent technology skills
• Ability to work under pressure to meet deadlines
• Ability to work flexible hours, if needed
• Ability to read, interpret, and apply laws, rules, and regulations
• Ability to plan, prioritize and coordinate multiple projects

Minimum Qualifications:

Education:

• Doctor of Medicine degree or Doctor of Osteopathic Medicine degree from an accredited institution
• Hospice and Palliative Medicine (HPM) Board Certification or Certificate of Added Qualification, and/or Hospice Medical Director Certification (HMDC)

Experience:

• Minimum of three years or more of clinical practice
• Minimum of two years in a clinical leadership role
• Participation in a leadership role in medical staff organization activities
• Experience in the treatment of end-of-life care
• Experience in public speaking
• Possess and maintain any and all applicable privileges with community hospitals
• Demonstrated understanding of the Centers for Medicaid and Medicare Services requirements
• Experience effectively collaborating with diverse groups

Licensures & Certifications:

• Possess and maintain any and all applicable privileges with community hospitals
• Valid, unrestricted, medical license to practice medicine in the state of North Carolina
• Board Eligible or Board Certified in Hospice and Palliative Medicine and/or Hospice Medical Director Certification, preferred
• Valid, unrestricted, DEA registration
• Valid driver's license and proof of automobile insurance

Summary of Physical Requirements:

• Hand dexterity to include gripping, carrying, pushing & pulling
• Fine finger movements to include writing & typing, frequently
• Flexion/Extension of arms & wrists
• Additional gross motor movements including: bending, reaching, twisting, turning, crouching, squatting, & kneeling
• Near & far visual acuity
• Ability to hear, understand, & distinguish speech and other sounds
• Prolonged standing & walking
• Prolonged sitting, in excess of four hours per day
• Ability to drive and/or transport self to and from work locations
• Ascending or descending stairs & ramps
• Ability to lift, carry, push & pull up to 10 pounds, occasionally

Intent and Function:

All descriptions have been reviewed to ensure that only essential functions and basic duties have been included. Peripheral tasks, only incidentally related to each position, have been excluded. Requirements, skills, and abilities included have been determined to be the minimal standards required to successfully perform the duties of the position. In no instance, however, should the duties, responsibilities, and requirements delineated be interpreted as all-inclusive. Additional functions and requirements may be assigned as deemed appropriate.

In accordance with the Americans with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals.

Job descriptions are not intended as and do not create employment contracts. The organization maintains its status as an at-will employer.