Medical Director - Exempt

State of Vermont•Waterbury, VT

11d

About The Position

The Medical Director (MD) reports directly to the Health Services Division Director within the Department of Corrections’ Office of Health, Wellness, and Engagement (HWE) and is responsible for providing medical expertise to the health system to drive quality improvement. The MD will collaborate closely with other members of DOC’s HWE. The MD will collaborate with and oversee clinical activities and work collaboratively across the Agency of Human Services (AHS) Departments in the interest of improving clinical programs while identifying effective and efficient ways to continually improve services and focus on improving the patient’s experience of care, including quality and satisfaction, and improving the health outcomes of AHS populations. The MD assists in resolving patient issues, develops quality and outcome measures to support overall health outcome improvements, represents the department at internal and external meetings. Serves as a clinical expert assisting and guiding departments clinical and non-clinical staff as it relates to best practice, standards of care that are evidence based. The MD will coordinate and collaborate with the department’s contracted comprehensive health services provider.

Requirements

Attainment of M.D. or D.O. degree and Board Certification in an ABMS approved specialty.
Current license to practice medicine in Vermont
Meets Vermont Medicaid credentialing standards
At least five years of clinical practice experience
Demonstrated success in a medical management leadership role
Expert knowledge of care management and quality improvement programs
Understanding of national and Vermont health reform initiatives
Experience providing healthcare to underserved communities with significant health risks.
Experience treating patients with acute and complex medical needs, such as but not limited to co-occurring substance use disorder, mental health, and medical disorders and conditions.
Experience with EQRO standards and process.
Familiarity with electronic health record systems
Functional knowledge of Microsoft Office including Word, Excel, and PowerPoint.
A strong ability to examine and document work processes, identify and recommend improvements in efficiency and effectiveness, and build procedures to ensure that successful results will be replicated is required.
Excellent verbal and written communication skills.
Advanced ability to build effective relationships (within company, within broader community), work effectively in a team-based environment, motivate, build consensus, negotiate, persuade, facilitate, resolve conflicts, demonstrate tact/sensitivity, and observe confidentiality.
Advanced ability to effectively prioritize work, multitask, direct/participate in group, demonstrate both independence and interdependence, exercise judgment, and work effectively in fast paced environment. Experience and skill in change management important.
Advanced ability to analyze clinical data from medical and pharmacy claims and medical record reviews to determine cost, quality, and efficiency of practice patterns
Proficiency building commitment and motivation in others toward the achievement of shared goals by effectively staffing, delegating and empowering, monitoring progress, providing feedback, and taking corrective action when appropriate. Strong budget development knowledge and budget administration skills are also required.
Must display commitment to expanding healthcare access, enhancing healthcare quality and improving health outcomes for Vermonters who experience systemic barriers that can contribute to poor health outcomes, such as identity-based discrimination or involvement in the criminal justice system.
M.D. or a D.O. with an active Vermont medical license in good standing.
At least five (5) years of clinical experience, three (3) of which must have involved leadership and management experience in the health care industry.

Nice To Haves

Addictionology certification or expertise in substance use disorder treatment preferred.

Responsibilities

Provide clinical support for review and adoption of all clinical guidelines.
Provide peer review of medical contractor’s clinical care audits and continuous quality improvement studies, as well as directly auditing contracted medical providers.
Provide independent physician oversight for high-risk and complex cases.
Enhance coordination and continuity of care through expert consultation.
Provide expertise regarding implementation of care outcomes metrics and initiatives to improve these outcomes.
Ensure DOC’s compliance with National Commission on Correctional Health Care standards including support during re-accreditation processes.
Strengthen the department’s internal clinical governance and compliance with healthcare standards.
Engage in discussions of clinical matters with external stakeholders such as physicians and other clinicians as well as Agency of Human Services and associated department staff as needed.
Review and evaluation of complex sentinel events, including identifying findings that need to be incorporated into continuous quality improvement processes.
Oversight and guidance in the management of diabetes, opioid use disorder, and other chronic conditions.
Participation in case reviews and system-level quality improvement efforts.
Provide medical expertise for utilization management and care management programs including internal programs and programs provided under contract or delegated to external entities, i.e.: AHS sister departments.
Provide clinical expertise coverage for the Health Services Division on evenings and weekends on a rotating basis, monitoring work communication channels to escalate or respond if emergency issues arise that need DOC support and/or intervention.
Support other AHS sister departments to advise on medical needs and policies as requested.