Medical Director - Outpatient Direct Clinical

Medical Director and Adult Outpatient Psychiatrist

Under the general supervision of the Chief Medical Director, the employee will function as the Medical Director and Clinical Psychiatrist for DWIHN's Direct Outpatient Clinics. This position will perform 80% direct care functions and 20% 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:

• Performs all duties and responsibilities required of a psychiatrist and provides quality and cost-effective care for the designated patient population in accordance with accepted medical standards and protocols.
• Performs psychiatric evaluations, re-evaluations, medication authorization, follow-up visits, and coordination with treatment teams.
• Performs primary care treatment and evaluation.
• Performs care and evaluations for clients with substance use disorders and individuals with dual diagnosis.
• Ensures timely documentation of notes.
• Diagnoses patients' mental health issues and treats them through medication and various forms of therapy.
• Participates in Alternative Treatment Order evaluations and fulfills all Mental Health Code requirements.
• Administers evidence-based medications and treatment for behavioral health disorders.
• Performs relevant diagnostic and laboratory tests as clinically indicated.
• Collaborates and supervises other Advance Practice Providers (APP) as needed and directed.
• Oversees and provides clinical supervision, discusses cases, and co-signs notes for APP.
• Serves as team lead for psychologists, nurses, and social workers to provide integrated and coordinated care.
• Develops and oversees treatment plans by determining the nature and extent of cognitive, emotional, developmental, social, and behavioral disorders and establishes treatment goals and methodologies.
• Discusses patient's progress toward goals with appropriate clinical staff.
• Maintains 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.
• Assures quality and safe service for patients and staff by enforcing policies, procedures, standards, rules, accreditation requirements and legal regulations.
• Maintains timely electronic medical records.
• Participates in continuing medical educational opportunities, reading professional publications, and participating in professional organizations.
• Provides crisis intervention when needed.
• Provides care compliant with licensing regulations and accreditation standards.
• Provides availability for calls regarding patients' - after-hours and on holidays, weekends, and in lieu of employee absences.
• Provides medication assisted treatment for substance use disorders.

Principal duties and responsibilities as the Medical Director:

• Leads and coordinates 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.
• Organizes, directs, and oversees the clinical activities and programs for all DWIHN Clinics.
• Provides 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.
• Provides clinical supervision to staff, including physicians and advanced practice providers.
• Monitor data and clinic KPIs.
• Monitors clinic productivity to ensure that clinic's targets are met.
• Ensures compliance with licensing, accrediting, regulatory, and third-party payer requirements in conjunction with Organizational leadership and staff.
• Participates in the development and implementation of grants, accreditations, and service expansions for the Clinic Services.
• Conducts ongoing assessment, planning, and oversight of proper clinic management and service delivery.
• Provides consultation by participating in case reviews, recommending appropriate treatment approaches, committees, and contributing to the establishment of psychiatric programs, policies, and procedures.
• Ensures that appropriate controls and training plans are in place for clinic staff related to clinic services.
• Develops and directs clinical rotations for residents, medical students, and other trainees.
• Teaches students, residents and fellows as assigned.
• Engages in publication, outreach, and community engagement activities on behalf of the clinic.
• Participates in and promotes quality improvement initiatives.
• Assumes responsibility for professional growth by current reading and attendance at educational programs and conferences.
• Maintains 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.
• Organizes and oversees the day-to-day operations of DWIHN clinics to ensure appropriate coverage.
• Ensures that DWIHN standards of service are maintained.
• Educates, enforces, and ensures team compliance with DWIHN policies and procedures.
• Cultivates, maintains, and enhances team, department, and interdepartmental relationships to promote collaboration, teamwork, and a positive working environment.
• Serves 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.
• Manages employee performance, including any verbal/written warnings and conducts employee evaluations to provide examples of behavior, ways for employees to improve performance, and development of employee goals.
• Leads assigned team in quality improvement initiatives and compliance with all standards to promote quality achievement across the organization.
• Manages work schedules, time and attendance, paid time off, and mileage for assigned staff.
• Reviews eligibility assessments for members receiving outpatient services at DWIHN Clinics.
• Provides 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.
• Coordinates with Medicaid Health Plans (MHP) for integration of services.
• Provides training specific to the application of medical necessity criteria for all referrals to the Network's program for comprehensive mental health services.
• Develops and implements new behavioral health programs to meet the needs of DWIHN members and community.
• Provides psychiatric expertise and consultation for complex cases.
• Monitors interdisciplinary teams by reviewing treatment plans and progress.
• Assists in decision making pertaining to the care of patients that is consistent with current medical practice and clinic policies and procedures.
• Oversees and is responsible for the quality, efficiency, and management of all services within the clinic.
• Develops care pathways and algorithms that improve client's care.
• Serves as a liaison between the clinic staff and DWIHN's organizational leadership.
• Serves in a teaching capacity providing behavioral health education and training as well as professional development to clinic staff.
• Maintains oversight of electronic records for timely documentation and other standards.
• Reviews medical records for quality checks to assure accuracy in meeting clinical, legal, and quality requirements.
• Assures quality and safety of service by enforcing policies, procedures, standards, and legal regulations.
• Analyzes data and trends at the DWIHN Clinics and prepares and presents reports to DWIHN's organizational leadership and to the Board of Directors as requested.
• Assists in the monitoring of the clinic's budget and revenue projections and goals.
• Promotes quality of care for DWIHN members.
• Monitors compliance with quality metrics including but not limited to HEDIS measures and other quality indicators.
• Participates in Root Cause Analysis and special Quality Assurance reviews.
• Provides consultations for disability designation of members.
• Provides 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.
• Collaborates with an interdisciplinary team to continuously improve productivity, efficiency, recovery outcomes, and medical care.
• Identifies and reports in a timely manner any health and safety risks, accidents, incidents, injuries, and property damage at the workplace.
• Serves on committees as designated by the Chief Medical Officer.