Commonwealth Care Alliance is a rapidly growing nonprofit organization providing integrated health care and social support services to people with complex medical needs. Our patients are seniors and persons with disabilities covered under Medicaid or both Medicaid and Medicare. Our innovative care model is nationally recognized for its effectiveness in improving health outcomes for these vulnerable populations.
Our unique care model is empowering for our employees as well as our members. Whether you are a clinical or administrative professional, all of us at Commonwealth Care Alliance receive the satisfaction of knowing our work truly makes a difference. We enjoy a company culture of passionate advocacy in a supportive work environment with opportunities for growth and learning, competitive salaries, and a generous and comprehensive benefit package.Position Summary
The Psychiatry Medical Director provides clinical oversight and leadership as well as direct care to CCA’s members with complex psychiatric, behavioral, and medical needs. He or she will report directly to the Chief of Psychiatry.
This position is responsible for providing psychiatric oversight to CCA’s program, with particular focus on engagement with CCA clinicians to ensure the successful achievement of key programmatic and quality objectives. This position will work with the Chief of Psychiatry and the Clinical Director of Psychiatry to lead the development of clinical practice guidelines, ensure appropriate clinical supervision of advanced practice clinicians, spearhead clinical quality and performance improvement initiatives, clinical risk management, achieve organizational and individual patient quality outcomes, and support clinical best practice adoption with specific focus on furthering the integration of behavioral health and primary care services. The direct patient care component to this role (at approximately 60% FTE) involves provision of psychiatric care to members in various settings including home, clinic, and crisis support units. Our crisis support units are an innovative addition to our comprehensive behavioral care which allows us to provide inpatient level of care for members who are able to function in a less restrictive setting, thus avoiding up to 70% of our psychiatric hospitalizations. The psychiatrist will also provide clinical supervision to home-visiting nurse practitioners, physician assistants and nurses
managing members with complex psychiatric, cognitive and behavioral health needs, as part of an interprofessional team. This psychiatrist will engage in care plan development, regular consultation and case review, and occasionally assuming full provider responsibilities for members with complex needs. Additionally, the Medical Director will participate in out-of-hours on-call duties as well as being available to telephonically to triage calls and discuss cases with other clinicians on the care team. Key Responsibilities
- Interface with PCPs, specialists, and hospitals to promote an understanding of CCA’s unique model, facilitate collaboration and shared decision-making
- Clinical oversight and supervision for advance practice clinicians delivering augmented primary care and care management to CCA members
- Monitoring, evaluation, and quality improvement activities
- Active participation in CCA’s Ethics Committee, Quality and Value Management Committee, Clinical Leadership Group, and the MD Group
- Active participation in quality improvement projects
- Program development and integration of clinical innovations, including community support units, care transitions, and others
- Development of educational content around psychiatric care, complex care delivery, substance use disorder, tailored to CCA / CCC clinicians
- Medical necessity reviews for acute (inpatient vs observation) level of care, as well as for service authorization requests
- Second level review of member appeals and quality of care concerns
- Quarterly review of CCA’s pharmacy trends and engagement in the annual formulary build, with specific focus on medications of particular relevance to the geriatrics population
- Responsibility for oversight of residents on occasion
- Interest in publication of innovations and policies.
- Provides clinical supervision to behavioral health NP/RN/PA and Behavioral health workers.
- Functions as clinical oversight for CCA Behavioral Health. Is available Monday – Friday 8 a.m. – 6 p.m. to provide clinical support for Advanced Practice Clinicians and RNs.
- Documents all clinical work in a timely manner and provides the necessary documentation required for data collection and billing purposes.
- Participates in all call responsibilities.
- Participates in “Doctor of the Day” responsibilities.
- Attends clinical team meetings and other mandatory educational sessions.
- Conducts educational and training activities that promote appropriate and effective patient care:
- Participates in the planning, implementation and coordination of psychiatric care to the patient and caregivers.
- Provides educational updates to clinical staff.
- Participates in orienting and training new employees as required.
- Participates in quality assessment and quality improvement within CCA as a whole
- Seeks to maintain a constructive work environment and maintains effective communication with other employees and managers
- Provides clinical oversight and supervision of NP/PA staff
- Communicates with primary care teams and coordinates post-acute follow up as needed
- Participates in case review and quality improvement projects
- Participates in annual clinical team retreats and social / teambuilding events
- Maintains required professional credentialing and appropriate CME standards
- Attends external meetings and activities as a representative of the organization as requested
- Individual will be responsible for making high-level clinical and managerial decisions
Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws
- High job complexity, requiring an advanced level of skill and both clinical and operational expertise. High tolerance for ambiguity.
- Office and home/community-based
- After-hours on-call responsibilities
- Occasional travel throughout Massachusetts
- MD or DO degree from an Accredited institution
- Board Certified or Board Eligible in Psychiatry
- Suboxone provider preferred, but not essential
- Interest and experience in serving underserved and disability populations is essential
- Experience with quality improvement, monitoring and evaluation, health systems strengthening, innovation and training is highly desired
- Experience in community-based psychiatry or substance abuse is helpful
- Proven skills, knowledge base and judgment necessary for independent clinical decision-making
- Excellent organizational, time-management and problem-solving skills
- Ability to function effectively as part of a multi-disciplinary team
- Effective oral and written skills
- Strong interpersonal skills
- Commitment to social justice in medicine and an understanding of healthcare reform
- Effective teaching and mentorship skills
- Ability to function in a busy environment and to make home visits in a community based setting. Visual and hearing ability sufficient to comprehend written/verbal communication and assessments of patients