Hospice Medical Director

Hospice Medical Director

Essential Duties & Responsibilities

• Work to achieve performance goals for self and for the Hospice Provider Team, pursue progress toward My Learning Plan (MLP) and demonstrate Four Seasons values and competencies 
• Consistently deliver patient care in accordance with agency guidelines and state and federal regulations and standards 
• Works with Leadership Team members and appropriate clinical directors to ensure quality patient care is delivered according to agency guidelines and state and federal regulations and standards 
• Support the ongoing development and implementation of policies and procedures that guide and support clinical practice standards and the provision of medical staff services
• Demonstrate effective supervision for the hospice physicians/providers while providing standards for excellence for all service and support lines, including education and training of clinical providers in hospice eligibility, certification, and recertification, proper documentation, and billing
• Conduct providers documentation reviews eligibility, billing, and clinical care
• Serve as a resource to staff on clinical issues, current trends in hospice medicine, and state and federal regulations 
• Represent the organization in a professional, competent manner in the community and consistently exhibit our Four Seasons’ CBRIGHTER values for internal and external stakeholders. 
• Serve as a member of Complex Case and Eligibility Reviews and oversee, direct, and support the rendering of medical management decisions that maximize benefits for patients and families while pursuing and supporting organizational objectives 
• Provide guidance for the Care Access Team to ensure patient eligibility, related/unrelated medication review, and accurate and timely completion of the Hospice Addendum.
• Provide clinical summaries for ADRs and audits and participate in the appeals process (redetermination, reconsideration, Administrative Law Judge hearings) and/or adjudication 
• Collaborate with Health Information Management (HIM) on the death certificate completion process and timely completion of outstanding orders.
• Represent the Agency on ad hoc committees as appropriate; interfaces with the provider community regarding medical review, utilization review, and quality assurance concerns 
• Provide clinical care when needed, including any care setting; participate in on-call medical coverage for hospice patients on a rotational basis with other hospice providers
• Serve as collaborating physician for Hospice and Palliative Care Advance Practice Providers; number will be determined by organizational best practice in accordance with state regulations 
• Participate in the accreditation and survey process
• Timely review and collaboration with Leadership Team and Quality/Compliance regarding service recoveries, occurrence reports, and sentinel events
• Represents Four Seasons in state, regional, and national forums, committees, etc. as available 
• Maintain a working knowledge of applicable National, State, and local laws and regulations, TJC Medicare and Medicaid Programs: Hospice Conditions of Participation and Payment, and other regulatory requirements related to the medical and allied health staff
• Participate in leadership training and meetings, organizational initiatives such as performance improvement (PI), goal planning, and strategic planning 
• Perform other but similar duties as assigned 

 Minimum Qualifications

Education:

• Doctor of Medicine degree or Doctor of Osteopathic Medicine degree from an accredited institution 
• Hospice and Palliative Medicine (HPM) Board Certification or Certificate of Added Qualification, and/or Hospice Medical Director Certification (HMDC), Preferred

Experience:

• Minimum of three years or more of clinical practice 
• Minimum of two years in a clinical leadership role
• Participation in a leadership role in medical staff organization activities 
• Experience in the treatment of end-of-life care 
• Experience in public speaking 
• Possess and maintain any and all applicable privileges with community hospitals 
• Demonstrated understanding of the Centers for Medicaid and Medicare Services requirements 
• Experience effectively collaborating with diverse groups

Licensures & Certifications:

• Possess and maintain any and all applicable privileges with community hospitals 
• Valid, unrestricted, medical license to practice medicine in the state of North Carolina 
• Board Eligible or Board Certified in Hospice and Palliative Medicine and/or Hospice Medical Director Certification, preferred 
• Valid, unrestricted, DEA registration 
• Valid driver’s license and proof of automobile insurance 

In accordance with the Americans with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals.