Under the direction of the CMO ( Chief Medical officer), Assistance Medical Director is the designated medical leadership for Denton County MHMR Center. Primarily responsible for directing psychiatric activities, monitoring trends and activities, diagnosing and treating clients and administering specialized psychiatric treatment and procedures. The Assistant Medical Director works collaboratively with the Director of Clinic Operations.

Provides clinical direction and leadership skills to other staff within the Center to maintain quality and continuity of care for the individuals served. Promotes the physical and mental health of individuals within the Center by applying psychiatric processes. Plans, assigns, and/or supervises the work of others. Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment.

Essential Elements of all Executive Leadership Team (ELT) Responsibilities

All ELT members serve at the pleasure of the Executive Director and while some member report directly to one of the Chiefs, all ELT members serve under the Executive Director's leadership. It is critical that all ELT members understand that they are held to a higher level of integrity than general staff.

Each member of ELT is expected to always maintain confidentiality of Center business.

This position services at the pleasure of the Executive Directive and as such is expected to exhibit loyalty, honesty, and integrity to the Executive Director always.

Education, Training and Experience (including licensure and certification)

Graduation from an accredited college of medicine with a degree as a medical doctor. Medical Doctor licensure in good standing, experience with individuals with chronic mental illness and addiction and supervisory experience required. Residency in the psychiatry field from an accredited program and board certification required.

REGISTRATION, CERTIFICATION, LICENSURE OR OTHER QUALIFICATIONS:

· Active DEA and Physicians Permits and Texas licenses, all in good standing.

· Board certification in the field of psychiatry.

· Experience providing clinical/medical supervision and administrative skills.

· All job specific training must be completed within 30 days of hire.

· Must maintain a valid Texas driver's license, auto liability insurance and a driving record acceptable to the Centers insurance requirements.

· Two years managerial experience preferred

Knowledge, Skills, and Abilities

· Knowledge of psychiatric principles and methods; of methods and procedures in general medicine; and of the principles and practices in the development, implementation, and documentation of individualized care and treatment plans.

· Skill in the care and treatment of patients, in the use of medical and psychiatric diagnostic and treatment tools and equipment, in conducting psychiatric research, and in the operation of computers and applicable computer software.

· Ability to direct psychiatric activities; to examine, diagnose, and treat mental disorders; to interpret psychological diagnoses and analyses; to communicate effectively; and to plan, assign, and/or supervise the work of others. Excellent written and verbal communication skills.

· Strong organizational and conflict resolution skills

· Must have valid Texas driver's license, proof of auto liability insurance, and maintain an acceptable driving record as defined by the Center's insurance carrier requirements.

· Must be able to perform the techniques of Prevention and Management of Aggressive Behavior (PMAB).

· Maintain current CPR certification and must be able to perform Cardiopulmonary Resuscitation (CPR).

· All job specific training must be completed within 30 days of hire.

· Must be willing to take on-call shifts if assigned.

· Must be willing to delegate prescriptive authority to Psychiatric Nurse practitioners.

· Ability to work with and treat individuals with sever and persistent mental illness

· Unrestricted eligibility to participate in provider network for Medicare/Medicaid/other third-party payers

· All job specific training must be completed within 30 days of hire.

· Must maintain a valid Texas driver's license, auto liability insurance and a driving record acceptable to the Centers insurance requirements.

· Excellent written and verbal communication skills.

· Strong organizational skills.

· Must be able to document and be proficient in using an Electronic health record.

· The assistant Medical Director may have the opportunity and shall be willing to serve as volunteer faculty to local medical schools, providing psychiatric training to medical students and/or residents.

Essential Duties include the following. Other duties may be assigned.

1. Provides evaluation, diagnostic, and medication management services according to applicable Texas Administrative Code, as outlined in the DCMHMR policies and procedures.

· Conducts a psychiatric evaluation. Explores and takes into account all relevant data sources in conduction and formulating diagnosis.

· Record the results of a primary evaluation and diagnosis in the clinical record and on the approved diagnostic tool using guidelines from current contract approved Diagnostic and Statistical Manual of Mental Disorders.

· Completes documentation on the same day.

· Diagnosis updates are done at least annually and additionally as necessary.

· Participates in On Call coverage

· Participates in providing cross coverage for clients when treating prescriber is unavailable.

Orders lab studies as recommended by prescribing guidelines and according to the DCMHMR Standing Lab Orders.

· Appropriate labs are ordered, available labs are reviewed appropriately when prescribing psychotropic medications.

· Reviews and signs off lab results in a timely manner.

· Addresses abnormal lab values appropriately and in a timely manner.

Prescribes medications and maintenance treatment to clients assigned to the individual doctor's and APRN's caseload and in emergency situations to those on other Denton County MHMR doctor's caseloads.

· Medications will be prescribed appropriate to the diagnosis and according to the appropriate DSHS approved medication treatment guidelines and documented on the DCMHMR Clinical Record Form.

· Psychotropic consent is obtained and AIMS done appropriately.

· Work cooperatively with the client using recovery-based language and incorporate the client's preferences for treatment when clinically appropriate.

· Patient and family education will be completed at each visit according to the Patient and Family Education (PFEP) program requirements and documented on the Denton County MHMR Clinical Record Form. This education will include information regarding diagnosis, treatment options, prescribed treatment, and recovery through self-monitoring and self-management.

· Will monitor and make recommendations regarding lab studies, according to the Denton County MHMR Standing Lab Orders and Abnormal Lab Value procedure.

· Avoid the use of polypharmacy and document clinical justification if required, following the DCMHMR Policies and Procedures regarding polypharmacy.

· Documents appropriately rational for prescribing and changes in the medication.

Provides crisis care to new adult or C & A clients referred by crisis teams as well as crisis services to existing adult or C & A clients.

· Provides Certificate of Medical Examinations when applicable and as soon as possible considering existing clinic schedules.

· Participates in telephonic on call rotation. Provides consultation to RNs and Crisis Residential Unit nursing as well as QMHP staff for medication treatment and other recommendations for existing as well as new clients being served by the crisis teams and Crisis Residential Unit clients. LPHA's serving the crisis teams may also access the doctor on call for non-medication recommendations.

· Provides crisis services during regularly scheduled hours.

Provides and documents each service according to rules and regulations outlined by the Medical Board, DCMHMR, the State Pharmacy Board, HHSC and TAC.

· Each note must contain the required elements for Medicaid or other third-party billing and must be completed as per center documentation completion policy.

· The attending psychiatrist will help facilitate filling out applications for disability benefits and prescription assistance programs and other form to facilitate client care and center operation when requested.

· The psychiatrist is to maintain consumer confidentiality and ethical standards.

2. Serves as a member of the treatment team and makes recommendations for plans of care.

· Seek consultation from the Medical Director and Psychiatric Peer Team on difficult cases and document this consultation.

· Refers clients to appropriate medical and community resources documenting this in the plan of care, eliciting assistance from case management, rehabilitation, and nursing staff.

· Provides consultation and orders regarding treatment, to the RNs and LVNs, regarding clients on each center prescriber's individual caseload or as the clinic doctor when a client's treating physician or APRN is not available for consultation. Sign verbal orders in a timely manner at the next available opportunity.

· Reviews each RN assessment at the client's next appointment when the RN is working under Standing Orders and provides suggestions or corrections as needed.

· Participates in Peer Review when applicable.

· Completes client care related paperwork appropriately and in a timely manner.

4. Provides clinical, programmatic operational oversight and leadership for the physicians, Advanced Practice Registered Nurses, contract physicians, and staff providing services at Denton County MHMR Center.

· Provided direct supervision of Psychiatrist and APRNs.

· Creates agenda for medical staff meetings.

· Ensures that employees are trained to perform their jobs and that various requirements of the position are communicated to the employee and are completed as per center policy.

· Ensures employees comply with education and training requirements of the center and regulatory authorities.

· Approves time off request of physicians and APRN

· Collaborates with Clinic operations Director for Doctor On Call schedule.

· Addresses any performance issues of direct reports in a timely manner.

· Monitors staff productivity.

· Assures clinic operational procedures including but not limited to APRN delegation, delegation to nurses and support staff is reviewed at least annually and signed.

· Collaborates with Clinic operation's director in resolving clinic operation related work flow and efficiency related matters.

5. Participate in, and provide oversight of, the Utilization Management Program's design and implementation when designated by CMO. Participate in QM relates activities when designated by CMO

· Functions as a UM Committee member

· Monitor the utilization of the clinic resources to assist in the promotion, maintenance, and availability of quality care in conjunction with effective and efficient utilization of resources.

· Participates in difficult case treatment review meetings.

· Monitors and oversees client transfer process. Reviews cases for appropriate conflict resolution. Addresses any patterns observes during this process.

· Participates in death review process in absence of CMO

6. Monitor and helps develop standards for quality care

· Audits charts on a regular basis for completion related to medication documentation, including informed consent documents and routine laboratory orders pertinent to each medication as well as any other issues that are identified.

· Monitors unsigned notes and works with individual prescriber to assure notes are signed in a timely manners.

· Regular reports will be forwarded to the CMO.

· Monitor any irregularities or problem trends detected in prescribing practice and address it at the next regularly scheduled medical staff meeting or individually as necessary. Communicates such trends with center CMO.

7. Infection control

· Oversees infection control program

· Monitors trends in infection related matters at the center and in the community and takes appropriate steps to help mitigate.

· Collaborates with DON to assure infection control related inspections are done as per policy.

8. Integrated care

· Works with CMO in overseeing Integrated care clinic

· Works with Clinic operations director in doing various audit to assure monitoring of supplies and quality measures.

9. Practices workplace safety procedures.

· Adheres to the use of Universal Precautions.

· Adheres to the Center Infection Control Plan.

· Informs appropriate staff of any safety hazard or issue promptly.

10. Attends regularly scheduled meetings.

· Attends regularly scheduled staff meetings.

· Attends regularly scheduled staff trainings.

· Attends regularly scheduled committee meetings.

· Attends regularly scheduled clinical team meetings.

11. Provides emergency intervention when necessary, according to Department of Human Services (DHS) and Center rules and procedures.

· Provides verbal and physical Prevention Management of Aggressive Behavior (PMAB) intervention correctly when necessary.

· Provides Cardiopulmonary Resuscitation (CPR) in an emergency until other medical aid arrives.

Provides emergency and non-emergency first aid until professional medical aid arrives or as directed by licensed medical professional.

· Maintains all emergency intervention training according to Denton County MHMR (DCMHMR) policies and procedures.

12. Provides courteous, professional services at all times.

· Provides appropriate customer service and demonstrates cultural sensitivity

· Supervise and delegate prescriptive authority to APRN

· Performs additional duties as assigned by Medical Director within designated timeframes.

· Demonstrates leadership, teamwork, dependability and customer service.

· Is available and approachable for consultation to nursing staff.

· Demonstrates willingness to work in walk- in clients and crisis clients.

· Works collaboratively with case managers and other treatment team members.

· Demonstrates cultural sensitivity and cultural awareness.

· Demonstrates ability to work with others to identify opportunities and resolve issues to achieve group goal.

· Willing to supervise and delegate prescriptive authority to APRN and provide appropriate supervision as required by law and governing Boards.

· Takes initiative and provides input towards the solutions.

13. Any additional duties as assigned by CMO.