Medical Director

Under the direction of the CMO (Chief Medical Officer), the Medical Director is the designated medical leadership for Denton County MHMR Center. Primarily responsible for directing psychiatric activities, monitoring trends and activities, diagnosing and treating clients and administering specialized psychiatric treatment and procedures. The Medical Director works administratively to implement policies and procedures that reflect evidence-based practice and quality delivery of care. The Medical Director leads our medical team, trains and supervises medical staff and manages medical operations that include but are not limited to patient safety, quality oversight, productivity, and supervision of medical staff.

The Medical Director works collaboratively with the Director of Clinic Operations.

Provides clinical direction and leadership skills to other staff within the Center to maintain quality and continuity of care for the individuals served. Promotes the physical and mental health of individuals within the Center by applying psychiatric processes. Plans, assigns, and/or supervises the work of others. Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment.

Education, Training, and Experience

• Graduated from an accredited college of medicine with a degree as a medical doctor.
• Texas Medical Doctor licensure in good standing.
• Experience with individuals with chronic mental illness and addiction and supervisory experience required.
• Residency in the psychiatry field from an accredited program and board certification required.
• Subspecialty fellowship in Child and adolescent and/or Addiction preferred.
• Two years of administrative, leadership and /or supervisory experience.
• Working knowledge of applicable national, state, and local laws and regulatory requirements.

Registration, Certification, Licensure, and Other Qualifications

• Active DEA and Physicians Permits and Texas licenses, all in good standing.
• Board certification in the field of psychiatry.
• Unrestricted eligibility to participate in provider network for Medicare/Medicaid/other third-party payers
• Experience providing clinical/medical supervision and administrative skills.
• Must be insurable by Center's liability carrier.
• Must have and maintain a background and criminal history free from any disqualifying offenses as outlined by the Texas Administrative Code (TAC) and the Health and Human Services Commission (HHSC).
• Must possess and maintain a valid driver's license and automobile insurance.

• Individuals with an out-of-state driver's license must be able to obtain a driver's license in the state of Texas within thirty (30) days.
• Successful completion of all position-specific training within thirty (30) days of employment is required.

Knowledge, Skills, and Abilities

• Knowledge of psychiatric principles and methods; of methods and procedures in general medicine; and of the principles and practices in the development, implementation, and documentation of individualized care and treatment plans.
• Skill in the care and treatment of patients, in the use of medical and psychiatric diagnostic and treatment tools and equipment, in conducting psychiatric research, and in the operation of computers and applicable computer software.
• Strong organizational and conflict resolution skills
• Excellent written and verbal communication skills.
• Proficiency in using and Electronic Health Record and ability to do parallel documentation.
• Ability to direct psychiatric activities; to examine, diagnose, and treat mental disorders; to interpret psychological diagnoses and analyses; to communicate effectively; and to plan, assign, and/or supervise the work of others. Excellent written and verbal communication skills.
• Ability to work with and treat individuals with sever and persistent mental illness
• Ability to handle multiple tasks and special projects simultaneously.
• Must be willing to take on-call shifts if assigned.
• Must be willing to delegate prescriptive authority to Psychiatric Nurse practitioners.
• The assistant Medical Director may have the opportunity and shall be willing to serve as volunteer faculty to local medical schools, providing psychiatric training to medical students and/or residents.
• Ability to display regular and reliable (in-person, if required) attendance.
• Understanding and practice of Trauma Informed Care principles.

Essential Duties

The following list outlines key responsibilities for the position; however, it is not exhaustive and does not encompass all responsibilities. Additional duties may be assigned as needed.

1. Provides evaluation, diagnostic, and medication management services according to applicable Texas Administrative Code, as outlined in the DCMHMR policies and procedures.

• Conducts a psychiatric evaluation. Explores and takes into account all relevant data sources in conduction and formulating diagnosis.
• Record the results of a primary evaluation and diagnosis in the clinical record and on the approved diagnostic tool using guidelines from current contract approved Diagnostic and Statistical Manual of Mental Disorders.
• Completes documentation on the same day.
• Diagnosis updates are done at least annually and additionally as necessary.
• Participates in On Call coverage
• Participates in providing cross coverage for clients when treating prescriber is unavailable.

2. Orders lab studies as recommended by prescribing guidelines and according to the DCMHMR Standing Lab Orders.

• Appropriate labs are ordered, available labs are reviewed appropriately when prescribing psychotropic medications.
• Reviews and signs off lab results in a timely manner.
• Addresses abnormal lab values appropriately and in a timely manner.

3. Prescribes medications and maintenance treatment to clients assigned to the individual doctor's and APRN's caseload and in emergency situations to those on other Denton County MHMR doctor's caseloads.

• Medications will be prescribed appropriate to the diagnosis and according to the appropriate DSHS approved medication treatment guidelines and documented on the DCMHMR Clinical Record Form.
• Psychotropic consent is obtained and AIMS done appropriately.
• Work cooperatively with the client using recovery-based language and incorporate the client's preferences for treatment when clinically appropriate.
• Patient and family education will be completed at each visit according to the Patient and Family Education (PFEP) program requirements and documented on the Denton County MHMR Clinical Record Form. This education will include information regarding diagnosis, treatment options, prescribed treatment, and recovery through self-monitoring and self-management.
• Will monitor and make recommendations regarding lab studies, according to the Denton County MHMR Standing Lab Orders and Abnormal Lab Value procedure.
• Avoid the use of polypharmacy and document clinical justification if required, following the DCMHMR Policies and Procedures regarding polypharmacy.
• Documents appropriately rational for prescribing and changes in the medication.

4. Provides crisis care to new adult or C & A clients referred by crisis teams as well as crisis services to existing adult or C & A clients.

• Provides Certificate of Medical Examinations when applicable and as soon as possible considering existing clinic schedules.
• Participates in telephonic on call rotation. Provides consultation to RNs and Crisis Residential Unit nursing as well as QMHP staff for medication treatment and other recommendations for existing as well as new clients being served by the crisis teams and Crisis Residential Unit clients. LPHA's serving the crisis teams may also access the doctor on call for non-medication recommendations.
• Provides crisis services during regularly scheduled hours.

5. Provides and documents each service according to rules and regulations outlined by the Medical Board, DCMHMR, the State Pharmacy Board, HHSC and TAC.

• Each note must contain the required elements for Medicaid or other third-party billing and must be completed as per center documentation completion policy.
• The attending psychiatrist will help facilitate filling out applications for disability benefits and prescription assistance programs and other form to facilitate client care and center operation when requested.
• The psychiatrist is to maintain consumer confidentiality and ethical standards.
• Maintains productivity as per center requirement.

6. Serves as a member of the treatment team and makes recommendations for plans of care.

• Seek consultation from the Chief Medical Officer and Psychiatric Peer Team on difficult cases and document this consultation.
• Refers clients to appropriate medical and community resources documenting this in the plan of care, eliciting assistance from case management, rehabilitation, and nursing staff.
• Provides consultation and orders regarding treatment, to the RNs and LVNs, regarding clients on each center prescriber's individual caseload or as the clinic doctor when a client's treating physician or APRN is not available for consultation. Sign verbal orders in a timely manner at the next available opportunity.
• Reviews each RN assessment at the client's next appointment when the RN is working under Standing Orders and provides suggestions or corrections as needed.
• Participates in Peer Review when applicable.
• Completes client care related paperwork appropriately and in a timely manner.

7. Provides clinical, programmatic operational oversight and leadership for the physicians, Advanced Practice Registered Nurses, contract physicians, and staff providing services at Denton County MHMR Center.

• Provided direct supervision of Psychiatrist and APRNs.
• Creates agenda for medical staff meetings.
• Ensures that employees are trained to perform their jobs and that various requirements of the position are communicated to the employee and are completed as per center policy.
• Ensures employees comply with education and training requirements of the center and regulatory authorities.
• Approves time off request of physicians and APRN
• Collaborates with Clinic Operations Director for Doctor On Call schedule.
• Addresses any performance issues of direct reports in a timely manner.
• Monitors staff productivity. Monitors and manages productivity of the medical staff in accordance with Key Performance Indicators (KPIs)
• Assures clinic operational procedures including but not limited to APRN delegation, delegation to nurses and support staff is reviewed at least annually and signed.
• Collaborates with Clinic Operations Director in resolving clinic operation related work flow and efficiency related matters.

8. Participates in, and provides oversight of, the Utilization Management Program's design and implementation when designated by CMO. Participate in QM related activities when designated by CMO

• Functions as a UM Committee member
• Monitors the utilization of the clinic resources to assist in the promotion, maintenance, and availability of quality care in conjunction with effective and efficient utilization of resources.
• Participates in difficult case treatment review meetings.
• Monitors and oversees client transfer process. Reviews cases for appropriate conflict resolution. Addresses any patterns observes during this process.
• Participates in death review process in absence of CMO
• Attends to bed day peer review appeals.
• Monitors quality relayed matters such as client clinic experience, KPI ( Key performance indicators), outcome measures, clinical safety reviews ie. Medication events, urgent Case reviews, root cause analysis and quality analytics.

9. Monitors and helps develop standards for quality care

• Audits charts on a regular basis for completion related to medication documentation, including informed consent documents and routine laboratory orders pertinent to each medication as well as any other issues that are identified.
• Monitors unsigned notes and works with individual prescriber to assure notes are signed in a timely manners.
• Monitors prescriber productivity
• Regular reports will be forwarded to the CMO.

Essential Elements of all Executive Leadership Team (ELT) Responsibilities

• All ELT members serve at the pleasure of the Executive Director and while some member report directly to one of the Chiefs, all ELT members serve under the Executive Director's leadership. It is critical that all ELT members understand that they are held to a higher level of integrity than general staff.
• Each member of ELT is expected to always maintain confidentiality of Center business.
• This position services at the pleasure of the Executive Directive and as such is expected to exhibit loyalty, honesty, and integrity to the Executive Director always.