Chief Medical Officer, Medicare - Los Angeles, CA, United States - Family Health Care Centers of Greater Los Angeles, Inc.

Description

Overview:

JOB TITLE:
Interim Chief Medical Officer


D EPARTMENT :
Administration


REPORTS TO:
Chief Executive Officer


PURPOSE :

As the leader of the provider team, FHCCGLAs CMO directs and supervises the clinical aspect of the agency, participates in the healthcare planning, implementation and ongoing development and evaluation of medical services as well as oversees Q.I./Q.A., Risk Management, PCMH and FTCA.

Responsibilities:
DUTIES AND RESPONSIBILITIES-ADMINISTRATIVE:
# Serves as the clinical strategist for FHCCGLAs executive management team.
# Represents the clinical side of aspects for the executive management team, the board and patients to ensure that decisions maximize patient care while ensuring to supporting FHCCGLAs long/short-term goals and objectives.
# Supervises, provides leadership and direction to the following professional staff:

• Physicians (M.D., D.O., etc.)
• Physician Assistants
• Locum Tenens
• Family Nurse Practitioners
• Pharmacist / P.I.C.
• L.C.S.W.
• L.V.N.s
• D.D.S.
• D.O.
• Behavioral Health Director
• R.D.
• R.N.
• Q.I./Q.A.-Risk Mngmt. Coord.
• M.A.
• D.P.M.
• Immunization Coordinator

# Sets the standard of professional performance for all medical and clinical support staff.
# Provides as-needed consultation support to all FHCCGLA providers and staff listed above by telephone or other electronic means.

# Establishes and updates/reviews (annually) all required medical policies & procedures (P&Ps) and protocols to ensure compliance with Federal requirements, standards of care and as directed by licensing, funding and/or other pertinent agencies (HRSA, FTCA, health plans, PCMH, CPSP, CHDP, Family PACT, etc.). Ensures that all standard medical P&Ps, protocols and guidelines are followed as required.
# Observes, revises and improves all current medical care standards, protocols and practices.
# Establishes benchmarks and sets clinical standards of professional performance for all medical staff to ensure that all patients are receiving the highest quality care.
# Works with FHCCGLAs executive management team to develop/meet short/long-term strategic plan objectives (as BOD approved) for service expansion or programs for a specific target population/site.
# Formulate, develop, and execute health care plans and program requirements.
# To continually improve medical practices, shall assist in developing and implementing programs, systems and processes that meet evidence based medical standards while ensuring the highest level of care to all FHCCGLA patients.
# Serves as the chair of the following committees:

# Medical Advisory Committee (MAC)- serves as the information resource to FHCCGLA providers for all performance measures, updates on clinical standards, pertinent matters applicable to clinical care guidelines and evidence based practices, productivity, Meaningful Use (MU), E.H.R., etc. During the MAC meetings also obtains providers input related to patient care, clinical concerns, opportunities for care improvement and FHCCGLAs healthcare delivery system.
# Quality Improvement (Q.I.) / Quality Assurance (Q.A.) Committee- serves as the information resource to the Executive Management Team, Board of Directors (BOD) or other relevant staff for all reporting pertaining to developments, program implementation and identified issues.


NOTE:
Q.I./Q.A. Report is presented to FHCCGLAs BOD on a quarterly basis.
# Peer Review- oversees peer review system to ensure that it is being done as required and addresses pertinent matters with individual providers as necessary.
# Corporate Risk Management Committee- serves as the information resource to the BOD for all reporting pertaining to risk management concerns, cases and system improvements to improve overall care at all FHCCGLA sites.


NOTE:
Risk Report presented to FHCCGLAs BOD on a quarterly basis.
# Credentialing & Privileging Committee- serves as the information resource to the BOD for all pertinent reporting related to developments.


NOTE:
Risk Management Report is presented to FHCCGLAs BOD annually.

# Measures/monitors Q.I./Q.A. through annual medical staff performance appraisals (PA) and peer review.


NOTE:
Forwards PA/recommendations to Human Resources (H.R.) to retain in the employees personnel file.
# Audits charts by conducting random chart reviews regularly.
# Regularly monitors the referral utilization review process and addresses any pertinent issues.
# Works with Chief Financial Officer (C.F.O.) and Chief Operating Officer (C.O.O.) to establish productivity levels for all providers and ensures the meeting of these goals.
# Takes overall responsibility to protect FHCCGLAs liability for all medical care services provided by the agency.
# Assumes legal responsibility in conjunction with the CEO for the pharmacy practices in compliance with state and federal guidelines.
# Shall ensure to adhere to all HRSA Program Requirements.
# Provides input on the appropriate staffing levels, equipment, supplies and facilities for all FHCCGLA clinic sites.
# Provides input on the evaluation of medical assistants (M.A.s) and other technical personnel assigned to patient care.
# Ensures compliance with applicable HCFA, Risk Management, OSHA, CLIA and other federal, state and institutional regulations.
# Shall assist in the implementation of Meaningful Use (M.U.) and Patient Centered Medical Home (PCMH) through collaborative efforts of key executive staff (e.g., C.E.O., C.O.O., IT Systems Administrator, Q.I./Q.A./Risk Management Coordinator, etc.).
# Assists with solutions to any problem that may arise in any area related to patient care that requires medical input.
# As part of the executive management team, the C.M.O. shall support and contribute toaccomplish the implementation of FHCCGLA's business plan and strategic planning for the agency.

24.

Delegates the medical team to the collaborative professional associations and participates in the collaborative activities (e.g., disease management, clinical advisory groups, CCALAC roundtables for Clinical Advisory Group (CAG), Dental, Pharmacy, etc.).

• Travel to and from clinic sites as scheduled and to attend pertinent meetings or conferences such as CCALAC, CPCA, NACHC, etc.
• Delineates clinical privileges and competencies.
• Provide other assistance and direction as needed and/or requested by the C.E.O.

Oversight and Guidance of:
#
# Medication Assisted Treatment Program
# Diabetes Clinic
# Self-Monitored Blood Pressure Program
# Immigration Services

#

• Undertakes continuous self-improvement, attending applicable training, seminars, in-services and

educational classes to maintain skills competency and current knowledge for standard of care and effective practices.

• Responsible for following all agency safety and health standards, regulations, procedures, policies and practices.
• Identifies, initiates and implements measures to deliver high quality care to patients and improve services.
• Responds efficiently and timely to all patient and provider staff needs and inquiries.
• Ensures excellent customer service to all FHCCGLA patients.
• Works with the operations managers to manage patient scheduling and flow to address bottlenecks,

scheduling issues, etc.

• Handles patient grievances according to FHCCGLAs Policy & Procedure.
• Assists in developing, updates & reviews of FHCCGLA Policies & Procedures (P&Ps) as needed (with input

from all other key personnel).

• Ensures HIPAA compliance by maintaining strict confidentiality of all patient data and E.H.R./Practice

Management System (PMS) according to regulations and FHCCGLAs P&Ps.

Attends the following meetings/trainings:
#
# Mandatory Quarterly Staff Meeting/Trainings- Quarterly (Jan., Apr., Jul. & Oct.)
# Corporate Risk Management Meeting- Quarterly (Jan., Apr., Jul. & Oct.), as needed (advanced notice will be provided when feasible).
# Clinical & Operations (C&O) Meeting- As needed (advanced notice will be provided when feasible)
# Meetings with FHCCGLAs Executive Leadership, as needed (advanced notice will be provided when feasible)

#

• Other pertinent meetings- As scheduled.

Remains informed of:
#
# Current legal and regulatory changes related to scope of practice.
# Specific programs/payors, insurances accepted, and services being offered at FHCCGLA.
# All applicable Policies & Procedures.

#

• FHCCGLA understands the importance of a well-balanced clinical schedule versus administration time

The following is allotted:
Clinical 50- 60% / Admin 40- 50%.

• All other duties as assigned.

CLINIC OPERATIONS:
Works with the C.O.O.

& the Clinical & Operations (C&O) Committee to:

# Implement new clinic operating processes and systems to enhance patient flow, provide quality care and address patient satisfaction survey corrective action plans (CAP).
# Ensure the efficient functioning of all clinic sites, coordination of provider schedules, compliance regarding supervision and health plan requirements related to provider hours available on-site.
# Comply with FHCCGLAs Credentialing & Privileging P&Ps.
# Review all patient grievances and implement measures to address grievance as necessary (e.g., meeting with provider, etc.).
# Oversee the medical portion all Medical Record Reviews (MRR) of the medical record audits (conducted for Q.A.) including proper documentation, review of laboratory reports, appropriate referral, continuity of care, identification of trends of the clinical practice and implementation of performance improvements with the Q.A. team.
# Provide oversight of the Immunization Coordinator to ensure that the Vaccines for Children (VFC) and adult vaccine programs are managed appropriately (e.g., avoidance of vaccine wastage, appropriate storage & handling, vaccine inventory, etc.).
# Ensure adherence to all FHCCGLA Policies as they relate to behavior, attendance, schedules, dress code, etc. by medical staff.
# Annually monitor the medical budget.


DIRECT PATIENT CARE:
# Performs patient assessments, physical examinations, order/performs necessary laboratory/diagnostic tests, proficiency testing, prescribe and dispense medications in compliance with FHCCGLA P&Ps.
# Adheres to universal precautions as set by the Centers for Disease Control (CDC), OSHA Occupational Safety & Health Administration.
# Maintains strict patient confidentiality.
# Completes thorough and timely documentation of patient care rendered, pertinent forms applicable to clinic visit, findings, recommendations and prescriptions at the conclusion of each clinic visit.
# Ensures positive interactions with all patients, visitors and staff with whom he/she interfaces.


Qualifications:

QUALIFICATIONS:
# Current valid license to practice in the State of California with no pending or prior disciplinary actions from any state licensing entity.
# Minimum 5-year healthcare management experience required.
# Demonstrated leadership ability, interpersonal skills and team management.
# Knowledge regarding treatment methods in the area of specialty and awareness of current medical, educational and psychosocial intervention procedures.
# Experience in developing, implementing and overseeing programs.
# Experience and knowledge of multi-ethnic and community-based clinic environments.
# Experience working with information technology (IT) staff to implement and manage sophisticated practice management and E.H.R. software.
# Ability to perform clinical responsibilities within FHCCGLAs guidelines in an efficient manner.
# Solid managerial, administrative and organizational skills.
# Creative skills, resourcefulness and judgement in managerial and administrative issues.
# Excellent analytical and reasoning skills.
# Expertise with low-income, indigent, ethnically and socially diverse patients.
# Ability to relate and communicate well with all individuals interfaced.
# Flexible with agency growth regarding work schedules and sites.
# Current DEA license.
# Board certified in the practice specialty.
# Current CPR certification.
# FQHC experience, highly preferred.
# Knowledge of administrative principles and procedures.
# Computer knowledge preferred (e.g., NextGen (E.H.R. & PMS), Microsoft Word and Excel).
# Bilingual English/Spanish and familiarity with the Hispanic culture.
# Access to automobile with valid California drivers license and state mandated automobile insurance.
# Work schedule may include evenings, overtime, and weekends as needed.
# Ability to prioritize workload and work under pressure of deadlines.
# Motivated and committed to the provision of high-quality healthcare for indigent and underserved communities.
# Willingness to adapt to changes with regards to the agencys growth and expansion.


ADDITIONAL ELIGIBILITY QULIFICATIONS:
# Ability to work well with others in a professional and team-oriented environment.
# Ability to relate to the public regardless of ethnic, religion and economic status.
# Willingness to travel.
# Problem analysis and critical thinking skills.
# Excellent customer service skills.
# Knowledge of the following (but not limited to), preferred:

• My Health LA
• Managed Care Plans
• Every Woman Counts
• CPSP
• Medicare
• PPOs
• Fee-for-Service
• CHDP
• Medi-Cal
• Family PACT
• HMOs

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