Description

JOB SUMMARY: Performs direct patient care in the medical office setting under the supervision of the Medical Director. Assures the adequacy and appropriateness of medical care provided to patients.

Note: All medical staff will be privileged and credentialed according to the rules and regulations of CSVS. The medical staff of each department or service is responsible for peer review activities to promote continuous improvement of the quality of patient care provided by the medical staff in all departments of CSVS.

DUTIES AND RESPONSIBILITIES:

• Directs and coordinates medical care at the medical office.
• Serves as a clinical director and medical practitioner for the medical office.
• Provides clinical supervision for medical office staff: physicians, nurses, physician assistants, etc.
• Participates in administrative decision making, establishes policies, procedures and guidelines designed to ensure the provision of adequate, comprehensive care across all specialties.
• Develops, revises, and implements policies and procedures for patient care, infection prevention and control, quality management and patients' rights.
• Understands and ensures compliance with the medical offices policies and procedures for safety, infection prevention and control, hazardous materials, and waste, etc.
• Communicates with the medical staff regarding policies, standards, and specific patient problems.
• Serves as a member of the organized medical staff, attends medical staff meetings, and ensures adherence to the medical staff bylaws and rules and regulations.
• Participates in the development and implementation of educational programs for staff and the community.
• Provides recommendations to CEO regarding capital expenditures for equipment and the facility.
• Able to evaluate medical services provided by the medical office and makes recommendations as appropriate.
• Available for consultation for clinical staff.
• Knowledgeable of social, regulatory, political, and economic factors that relates to patient care services.
• Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors.
• Supports and maintains a culture of safety and quality.
• Advises CEO concerning the adequacy and appropriateness of the medical offices scope of services for patients, its professional and support staff, and its medical equipment.
• Monitors and evaluates the quality and appropriateness of medical services as an integral part of the overall quality management program.
• Provides medical leadership for research and development activities in patient care.
• Articulates the medical practices mission to the community.

QUALITY IMPROVEMENT:

• Assists with the development and implementation of the Quality Improvement Plan of the organization.
• Provides an annual review of staff performance, including tracking staff hours, patient encounters, productivity, member complaints and member satisfaction surveys.
• Monitors the results of the Physician Satisfaction Surveys and implements corrective action when necessary.
• Refers appropriate cases to the Quality Management Committee for action and problem resolution.
• Assists the organization in obtaining accreditation status.
• Assists the CEO in the development and expansion of a system wide wellness program.

UTILIZATION REVIEW:

• Develops, implements, and monitors the Utilization Review Plan.
• Develops practice guidelines for high volume diagnoses in conjunction with the appropriate specialists.
• Educates staff about utilization practices to promote high-quality, cost-effective care.
• Develops written policies for the resolution of utilization problems.
• Plans and conducts interventions with outlier physicians.
• Assists in the growth and development of the Case Management program.
• Acts as a resource for the Utilization Review Coordinators.
• Reviews frequent or unusual referral requests.
• Interfaces with health plan Medical Directors as needed on utilization issues.

PROVIDES DIRECT PATIENT MEDICAL CARE:

• Performs histories and physicals.
• Makes diagnoses.
• Treat a variety of disease processes and acute injuries.
• Orders appropriate diagnostic tests and treatments.
• Prescribes drugs and regulated medical devices.
• Provide preventive healthcare education to patients and the community.
• Refers patients to other healthcare professionals as appropriate.
• Takes patient phone calls as needed.
• Provides clinical training to nurses and other staff.

Qualifications

PROFESSIONAL REQUIREMENTS:

• Adheres to dress code, appearance is neat and clean.
• Maintains regulatory requirements, including all federal, state, local regulations and accrediting organization standards.
• Always maintains patient confidentiality.
• Wears identification while on duty.
• Represents the organization in a pleasant, positive, and professional manner.
• Complies with all organizational policies regarding ethical business practices.
• Communicates the mission, ethics, and goals of the facility, as well as the focus statement of the department.

EDUCATION:

• Currently licensed to practice medicine in the State of California.
• Current Board Certification.
• Current Drug Enforcement Administration Registration.
• Presentation of Certificate of Insurance.
• Previous experience in a managed care environment, including experience in quality and utilization management.

LANGUAGE SKILLS:

• Able to communicate effectively both verbally and in writing.
• Excellent interpersonal skills.
• Other languages preferred.

SKILLS & ABILITIES:

• Basic computer knowledge.

ENVIRONMENTAL/WORKING CONDITIONS:

• Combination of medical office and exam/procedure room settings.
• Well-lighted, well-ventilated, adequate space.
• Exposure to communicable diseases and other conditions common to clinic setting.

PHYSICAL/MENTAL DEMANDS:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care.

Please note that this job description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Requirements

1. Resume (if available).
2. Application/Candidate Profile.
3. Immunization record (showing completion of MMR, HEP B, Flu, Covid-19 Dose (Comirnaty or Spike)
4. PPD documentation within 1 year. (Individuals with a history of a positive PPD must provide a note for their provider indicating they are free of active disease, a blood test or chest x-ray with the last year.)