Medical Director- Inpatient Services

US-CA-Commerce
Job ID
2017-4269
Category
Physician

Overview

Provides inpatient hospital care at AltaMed contracted hospital/SNF facilities and assists Hospital/SNF physician(s) in the timely coordination of inpatient care, discharge Planning and outpatient medical care as requested by Hospital physician(s). Provides professional services to include all inpatient professional services, including evaluation and management, coordination and provision of inpatient medical services, discharge planning, and utilization management and oversight of services provided in an inpatient setting. Provides oversight and management of AltaMed staff hospitalists/SNFist and contracted network hospitalists/SNFists, oversees planning, operations, budget oversight of AltaMed Hospitalist/SNFist program.

 

Complies and participates in the quality assurance/improvement as programs are established or amended by Contracted Health Plans and by AltaMed, as approved by DHCS and DOC. Oversight of compliance adherence in securities to project the privacy and provide security PHI compliance, HIPAA, HITECH and related applicable laws and regulations under California's Health and Safety codes. Including adhering to utilization or quality assurance reviews, within agreement to applicable state and federal regulatory agencies, including California Department of Managed Health Care, for compliance of the Contracting Health Plan with the rules and regulations of such agencies, including provisions of the Knox-Keene Health Care Service Plan Act of 1975 and applicable regulations.

 

Responsibilities

  1. Adheres to render Professional Hospitalist Services to Members assigned to AltaMed Primary Physicians who are admitted to designated Hospitals.
  2. Provides inpatient patient care services to include daily rounding of hospitalized patients; participates in patient rounding at specified times; and coordination efforts with Medical Management (MM) team members.
  3. Assessment of patient needs including discharge inpatient, treat regardless of clinic or other non-inpatient responsibilities.
  4. Oversees and delivers monthly calendar to MM team to specify daily coverage; coordinates with MM to collaborate on the appropriateness of observation status, admissions and/or continued stay.
  5. Coordination with MM team to collaborate on care transitions to Home Health/SNF/Acute Rehabilitation.
  6. Coordinates central intake for case management to determine covering hospitalist for specific patients.
  7. Facilitation of transition to an in-network hospital when patient presents or is admitted to a non-contracted hospital where appropriate.
  8. Participates in and attends regional and/or sub-regional POD meetings (for the POD in which the hospital covered encompasses) with the Medical Director, UM, billing and contracting departmental representatives as well as Hospital representatives (at minimum quarterly) basis.
  9. Oversees the discharge documentation of conversations related to treatment orders inclusive of continuance of care to other care providers/patient/family members and a clearly worded care summary. This includes discharge planning required in both hospital and skilled nursing settings.
  10. Generates expedited discharges and is fully engaged with Case Management, Primary Care Physician, and/or other specialist and/or other team personnel in developing the discharge plan of members prior to/or in the expedited discharge, with goal in mind to avoid potential readmission.
  11. Develop/oversee an ER diversion program to add protocol to redirecting members to the appropriate level of care as recommended by evidence of based guidelines.
  12. Assessments of ER level admissions while assisting ER diversion where appropriate and addresses end-of-life issues in a sensitive and timely manner, including completion of POLST or DNR when indicated.
  13. Ensures accurate Medical reconciliation during the members stay. Communicates medication discrepancies; takes the lead in coordination with other team members in development of a clear and concise discharge medication plan that includes a reconciled medication list combined with physician to member discussion of medication potential interactions or adverse side effects.
  14. Leads the development of care pathways and other programs designed to improve outcomes while preventing common hospital associated, acquired conditions that may complicate inpatient stays.
  15. Reporting of all admissions, discharges and care planning as well as other information necessary to track and analyze inpatient, ER and SNF activity for AltaMed members on a daily basis through AltaMed's established electronic, telephonic or other methods of communication as defined by AltaMed.
  16. Communicate to Primary Care and Specialty Care physicians within 24 hours of discharge.
  17. Applies the SNFist Service Level Requirements to include: round twice a week, admission assessment in person within 48 hours of admission, available to round weekly with SNF Medical Management teams and participate in MM Interdisciplinary Care Team meetings when applicable.
  18. Develop and coordinate training and daily performance metrics/workflows for inpatient case management teams.
  19. Collaborate with Medical Management leadership to coordinate, train, and staff complex/high risk outpatient clinics for recently discharged patients.
  20. Oversee and manage performance of staff and contracted hospitalist/SNFists.

 

Qualifications

  1. Must have previous Hospitalist experience, SNFist experience preferred.
  2. Current California license and certification as required.
  3. Prefer if candidate already has hospital privileges at (list hospitals); or must be able to obtain privileges.

 

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed

Connect With Us!

Not ready to apply? Connect with us for general consideration.