AHS Medical Director - Exempt

AHS Medical Director - Exempt

The Medical Director (MD) reports directly to the Agency of Human Services (AHS) Secretary or Secretary's designee and is responsible for providing medical expertise to AHS departments: Department of Corrections (DOC), Department of Disabilities, Aging and Independent Living (DAIL), Department of Mental Health (DMH), and the Department of Children and Families (DCF) and their health systems to ensure and drive further quality improvement. The MD will collaborate closely with staff and contracted health providers in all the departments. The MD will oversee clinical programs across the AHS Departments in the interest of ensuring their clinical and operational alignment. The MD will identify effective and efficient ways to continually improve the programs' services with a focus on improving the patient's experience of care, including quality and satisfaction, and the overall goal of improving the health outcomes of AHS populations. The Medical Director will also provide clinical leadership and physician oversight related to the AHS forensic facility, including clinical services for incarcerated individuals who may have complex co-occurring needs such as mental health and/or substance use disorders, medical disorders, developmental or intellectual disabilities, or competency-restoration service needs. The Medical Director will support the development and implementation of clinical standards, policies, treatment programming, and quality oversight for forensic programming and will provide independent medical review where required by law, rule, or Agency policy. The MD will coordinate and collaborate with the DOC's contracted comprehensive health services provider. The MD assists in resolving patient care issues, develops quality and outcome measures to support overall health outcome improvements, represents the department at internal and external meetings. Serves as a clinical expert assisting and guiding departments clinical and non-clinical staff as it relates to best practices and standards of care that are evidence based.

Primary Responsibilities:

• Provide clinical support for review and adoption of all clinical guidelines.
• Provide peer review of medical contractor's clinical care audits and continuous quality improvement studies, as well as directly auditing contracted medical providers.
• Provide independent physician oversight for high-risk and complex cases.
• Enhance coordination and continuity of care through expert consultation.
• Provide expertise regarding implementation of care outcomes metrics and initiatives to improve these outcomes.
• Ensure DOC's compliance with National Commission on Correctional Health Care standards including support during re-accreditation processes.
• Strengthen department's internal clinical governance and compliance with healthcare standards.
• Engage in discussions of clinical matters with external stakeholders such as physicians and other clinicians as well as Agency of Human Services and associated department staff as needed.
• Review and evaluation of complex sentinel events, including identifying findings that need to be incorporated into continuous quality improvement processes.
• Oversight and guidance in the management of diabetes, opioid use disorder, and other chronic conditions.
• Participation in case reviews and system-level quality improvement efforts.
• Provide medical expertise for utilization management and care management programs including internal programs and programs provided under contract or delegated to external entities, i.e.: AHS sister departments.
• Where possible seek to align the contractor's utilization management and care management programs with those of the Vermont Medicaid program, as well as with relevant DMH, VDH, DCF, and DAIL programs
• Provide coverage for the Health Services Division of the Department of Corrections on evenings and weekends on a rotating basis, monitoring work communication channels to escalate or respond if emergency issues arise that need DOC support and/or intervention.
• Support other AHS sister departments to advise on medical needs and policies as requested.
• Provide physician leadership and consultation in the development, implementation, and ongoing oversight of clinical standards for AHS forensic services and programming.
• Provide independent physician review, consultation, or authorization for clinical decisions involving individuals receiving forensic services when required by statute, rule, court order, or Agency policy.
• Collaborate with DOC, DMH, VDH, DCF, and DAIL contracted health care providers, the Judiciary, and other partners as appropriate regarding the clinical needs of individuals involved in the criminal justice system.
• Participate in the development and review of clinical protocols addressing complex forensic issues, including competency-related services, medication management, continuity of care, co-occurring mental health and substance use needs, and transitions between correctional, inpatient, residential, and community settings.

Competencies, Knowledge, Skills & Abilities:

Experience and Subject Matter Expertise:

• Attainment of M.D. or D.O. degree and Board Certification in an ABMS approved specialty. American Board of Preventative Medicine certification in Addiction Medicine or Board eligible preferred. Psychiatry strongly preferred.
• Current license to practice medicine in Vermont
• Meets Vermont Medicaid credentialing standards
• At least five years of clinical practice experience
• Demonstrated success in a medical management leadership role
• Expert knowledge of care management and quality improvement programs
• Understanding of national and Vermont health reform initiatives
• Experience providing healthcare to underserved communities with significant health risks.
• Experience treating patients with acute and complex medical needs, such as but not limited to co-occurring substance use disorder, mental health, and medical disorders and conditions.
• Experience with EQRO standards and process.
• Familiarity with electronic health record systems

Computer Skills (or other technical skills) Must have functional knowledge of Microsoft 365 including Word, Excel, and PowerPoint.

Process Improvement Knowledge and Abilities A strong ability to examine and document work processes, identify and recommend improvements in efficiency and effectiveness, and build procedures to ensure that successful results will be replicated is required.

Communication Skills Excellent verbal and written communication skills.

Interpersonal Skills Advanced ability to build effective relationships (within company, within broader community), work effectively in a team-based environment, motivate, build consensus, negotiate, persuade, facilitate, resolve conflicts, demonstrate tact/sensitivity, and observe confidentiality.

Organizational Abilities Advanced ability to effectively prioritize work, multitask, direct/participate in group, demonstrate both independence and interdependence, exercise judgment, and work effectively in fast paced environment. Experience and skill in change management is important.

Analytical Skills Advanced ability to analyze clinical data from medical and pharmacy claims and medical record reviews to determine cost, quality, and efficiency of practice patterns.

Leadership This position requires proficiency building commitment and motivation in others toward the achievement of shared goals by effectively staffing, delegating and empowering, monitoring progress, providing feedback, and taking corrective action when appropriate. Strong budget development knowledge and budget administration skills are also required.

Commitment to health equity Must display commitment to expanding healthcare access, enhancing healthcare quality and improving health outcomes for Vermonters who experience systemic barriers that can contribute to poor health outcomes, such as identity-based discrimination or involvement in the criminal justice system.

Compensation: Anticipated approximate starting salary range from $200k to $270k.

Equal Opportunity Statement: The State of Vermont celebrates diversity, and is committed to providing an environment of mutual respect and meaningful inclusion that represents a variety of backgrounds, perspectives, and skills. The State does not discriminate in employment on the basis of race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, membership in an employee organization, family medical history or genetic information, or family or parental status. The State's employment decisions are merit-based. Retaliatory adverse employment actions by the State are forbidden.