MEDICAL DIRECTOR OUTPATIENT DIRECT CLINICAL

Medical Director Outpatient Direct Clinical

Under the general supervision of the Chief Medical Director and the Executive Director of Outpatient Services, the Psychiatrist Outpatient employee will function as the Medical Director and Clinical Psychiatrist for DWIHN's Direct Outpatient Clinics. This position will perform 90% direct care functions and 10% administrative functions. The Psychiatrist will provide medical direction, guidance, planning, and supervision for all outpatient behavioral health programs and provide quality care to DWIHN members.

Principal duties and responsibilities include performing all duties and responsibilities required of a psychiatrist and providing quality and cost-effective care for the designated patient population in accordance with accepted medical standards and protocols. The Psychiatrist will perform psychiatric evaluations, re-evaluations, medication authorization, follow-up visits, and coordination with treatment teams. They will also provide primary care treatment and evaluation, care and evaluations for clients with substance use disorders and individuals with dual diagnosis, and ensure timely documentation of notes.

The Psychiatrist will diagnose patients' mental health issues and treat them through medication and various forms of therapy. They will participate in Alternative Treatment Order evaluations and fulfill all Mental Health Code requirements. The Psychiatrist will administer evidence-based medications and treatment for behavioral health disorders, perform relevant diagnostic and laboratory tests as clinically indicated, and collaborate and supervise other Advance Practice Providers (APP) as needed and directed.

The Psychiatrist will serve as team lead for psychologists, nurses, and social workers to provide integrated and coordinated care. They will develop and oversee treatment plans by determining the nature and extent of cognitive, emotional, developmental, social, and behavioral disorders and establish treatment goals and methodologies. The Psychiatrist will discuss patient's progress toward goals with appropriate clinical staff and maintain interdisciplinary treatment by reviewing treatment plans and progress, and consulting and collaborating with primary care physicians, mental health therapists, nurses, and other health care providers.

The Psychiatrist will assure quality and safe service for patients and staff by enforcing policies, procedures, standards, rules, accreditation requirements, and legal regulations. They will maintain timely electronic medical records, participate in continuing medical educational opportunities, reading professional publications, and participating in professional organizations. The Psychiatrist will provide crisis intervention when needed and provide care compliant with licensing regulations and accreditation standards.

The Psychiatrist will provide availability for calls regarding patients' after-hours and on holidays, weekends, and in lieu of employee absences. They will provide medication assisted treatment for substance use disorders. Principal duties and responsibilities as the Medical Director include leading and coordinating the development and implementation of integrated, strategic medical and clinic plans, policies, and procedures for the Clinics that effectively communicate and support the mission, vision, and achievement of overall business operations and clinical outcome objectives.

The Medical Director will organize, direct, and oversee the clinical activities and programs for all DWIHN Clinics. They will provide overall leadership and guidance to the Clinic department by overseeing prescriber, nursing, and administrative support staff to ensure the efficient delivery of medical, nursing, and support services. The Medical Director will provide clinical supervision to staff, including physicians and advanced practice providers.

The Medical Director will monitor clinic productivity to ensure that clinic's targets are met. They will ensure compliance with licensing, accrediting, regulatory, and third-party payer requirements in conjunction with Organizational leadership and staff. The Medical Director will participate in the development and implementation of grants, accreditations, and service expansions for the Clinic Services. They will conduct ongoing assessment, planning, and oversight of proper clinic management and service delivery.

The Medical Director will provide consultation by participating in case reviews, recommending appropriate treatment approaches, committees, and contributing to the establishment of psychiatric programs, policies, and procedures. They will ensure that appropriate controls and training plans are in place for clinic staff related to clinic services. The Medical Director will develop and direct clinical rotations for residents, medical students, and other trainees. They will teach students, residents, and fellows as assigned.

The Medical Director will engage in publication, outreach, and community engagement activities on behalf of the clinic. They will participate in and promote quality improvement initiatives. The Medical Director will assume responsibility for professional growth by current reading and attendance at educational programs and conferences. They will maintain knowledge and compliance with established policies and procedures, corporate compliance programs, code of ethics, applicable federal, state, and local laws and regulations, HIPAA standards, and other regulatory programs.

The Medical Director will organize and oversee the day-to-day operations of DWIHN clinics to ensure appropriate coverage. They will ensure that DWIHN standards of service are maintained. The Medical Director will educate, enforce, and ensure team compliance with DWIHN policies and procedures. They will cultivate, maintain, and enhance team, department, and interdepartmental relationships to promote collaboration, teamwork, and a positive working environment.

The Medical Director will serve as a role model, mentor, and coach in providing ongoing and consistent individual supervision that is focused on meeting individual productivity and performance goals, as well as departmental goals, objectives, and project deadlines. They will manage employee performance, including any verbal/written warnings and conduct employee evaluations to provide examples of behavior, ways for employees to improve performance, and development of employee goals.

The Medical Director will lead assigned team in quality improvement initiatives and compliance with all standards to promote quality achievement across the organization. They will manage work schedules, time and attendance, paid time off, and mileage for assigned staff. The Medical Director will review eligibility assessments for members receiving outpatient services at DWIHN Clinics.

The Medical Director will provide oversight and support for the following on request of the PIHP: utilization management/review; denial of services, appeals; retrospective reviews; reporting and review of deaths; reporting and review of sentinel events; behavior treatment plans, and clinical aspects of Medicaid Fair Hearings. They will coordinate with Medicaid Health Plans (MHP) for integration of services. The Medical Director will provide training specific to the application of medical necessity criteria for all referrals to the Network's program for comprehensive mental health services.

The Medical Director will develop and implement new behavioral health programs to meet the needs of DWIHN members and community. They will provide psychiatric expertise and consultation for complex cases. The Medical Director will monitor interdisciplinary teams by reviewing treatment plans and progress. They will assist in decision making pertaining to the care of patients that is consistent with current medical practice and clinic policies and procedures.

The Medical Director will oversee and be responsible for the quality, efficiency, and management of all services within the clinic. They will develop care pathways and algorithms that improve client's care. The Medical Director will serve as a liaison between the clinic staff and DWIHN's organizational leadership. They will serve in a teaching capacity providing behavioral health education and training as well as professional development to clinic staff.

The Medical Director will maintain oversight of electronic records for timely documentation and other standards. They will review medical records for quality checks to assure accuracy in meeting clinical, legal, and quality requirements. The Medical Director will assure quality and safety of service by enforcing policies, procedures, standards, and legal regulations.

The Medical Director will analyze data and trends at the DWIHN Clinics and prepare and present reports to DWIHN's organizational leadership and to the Board of Directors as requested. They will assist in the monitoring of the clinic's budget and revenue projections and goals. The Medical Director will promote quality of care for DWIHN members.

The Medical Director will monitor compliance with quality metrics including but not limited to HEDIS measures and other quality indicators. They will participate in Root Cause Analysis and special Quality Assurance reviews. The Medical Director will provide consultations for disability designation of members.

The Medical Director will provide clinical coverage and consultation on any urgent clinical issue that may arise between the time that members contact the Access center and the time they are seen by providers. They will collaborate with an interdisciplinary team to continuously improve productivity, efficiency, recovery outcomes, and medical care. The Medical Director will identify and report in a timely manner any health and safety risks, accidents, incidents, injuries, and property damage at the workplace.

The Medical Director will serve on committees as designated by the Chief Medical Officer. They will perform all other related duties as assigned by DWIHN's Chief Medical Officer.

Knowledge, skills, and abilities (KSA's) include knowledge and experience with the Accreditation and Certification Standards Joint Commission. Knowledge of DWIHN policies, procedures, and practices. Knowledge of the DWIHN provider network and community resources. Knowledge of the Michigan Mental Health Code. Knowledge of MDHHS policies, rules, regulations, and procedures. Knowledge of Federal policies, rules, regulations, and procedures as it relates to DWIHN. Knowledge of the clinical care process (screening, assessment, treatment planning, case management, and continuing care). Knowledge of and ability to use screening and assessment tools for behavioral health services. Knowledge of medical and behavioral health practices and terminology. Knowledge of compliance standards. Knowledge of Medical Necessity Criteria for Behavioral Health Services. Knowledge of documents / regulations that govern the provision of mental health services, e.g., Medicaid Manual Mental Health and Substance Abuse Chapter III, State Plan for Medicaid, Michigan Department of Health and Human Services Quality Plan, BBA requirements and the Mental Health Code. Knowledge of the practices and principles of psychological, emotional, and sociological assessment and diagnosis. Knowledge of diagnostics, psychopharmacology, and supportive treatment approaches as applied to a severely mentally ill (SMI) adult population. Knowledge of diagnostics, psychopharmacology, and

Community Mental Health Partnership of Southeast Michigan