Collaborating Physician

Vynca•San Mateo, CA

1d•$700 - $800

About The Position

The Collaborating/Supervising Physician provides clinical oversight, delegates medical services, and offers consultation to Vynca Advanced Practice Providers (APPs) delivering home-based palliative and serious illness care to adult and pediatric patients across California’s western region. The physician supervises nurse practitioners practicing under standardized procedures and a practice agreement, and may supervise up to four NPs at one time. The physician is responsible for ensuring delegated medical services are clinically appropriate, properly documented, and compliant with California law and applicable medical and nursing board rules. The role includes maintaining written nurse protocol agreements, being available for consultation, reviewing patient records and outcomes, monitoring quality of care, and supporting clinical governance and quality improvement. The physician also supports symptom management, advance care planning, goals-of-care conversations, and, where permitted and clinically appropriate, delegation related to death pronouncement and death certificates. The principal place of practice must be in California.

Requirements

Active, unrestricted California medical license (MD or DO) in good standing.
Willingness and ability to obtain additional licensure as needed.
Active DEA registration.
Principal medical practice location within California.
Board certification in Family Medicine, or in Internal Medicine and Pediatrics.
Demonstrated experience supervising or collaborating with advanced practice providers.
Familiarity with value-based care and California supervision requirements for nurse practitioners.

Nice To Haves

Additional licensure in Washington, Oregon, Utah, and Idaho is highly preferred.
Experience supervising or collaborating with advanced practice providers in home-based or serious illness care.

Responsibilities

Serve as supervising physician for up to four nurse practitioners at a time, within the scope of the physician’s specialty and training in palliative and primary care.
Coordinate with Vynca to establish, review, and maintain written nurse protocol agreements for each nurse practitioner and ensure agreements and amendments are filed with the Medical Board within required timelines.
Be immediately available for consultation during care delivery or designate a qualified backup physician who agrees to the applicable agreements.
Attend interdisciplinary team (IDT) meetings at least monthly for one hour, with participation potentially required up to one hour weekly.
Review and countersign patient records as required by standardized procedures and practice agreements, including records for patients receiving controlled substances from an APP.
Review 100% of patient records involving an adverse outcome within 30 days of discovery, per Vynca program standards.
Review a sample of at least 10% of other patient records quarterly, following Vynca program standards and the method defined in each standardized procedure and practice agreement.
Conduct medical record reviews and meetings with APRNs at least quarterly to monitor quality of care.
Provide direct virtual observation of each APP’s practice if required, with audit methods and frequency defined by the practice agreement.
Support symptom management, advance care planning, and goals-of-care conversations in alignment with Vynca’s care model.
Where clinically appropriate and permitted by California law, delegate authority to pronounce death and complete death certificates through the applicable standardized procedure or practice agreement.
Guide controlled substance management within California law for NP furnishing, including patient-specific protocols, risk assessment, counseling, CURES consultation, and naloxone requirements.
Maintain a principal place of practice in California.
Support continuity of oversight during physician transitions, including prompt updates to standardized procedures and practice agreements.
Participate in clinical governance, case review, and quality improvement activities as directed by the Chief Medical Officer.