Supervised by: Executive Director

Days Off: Saturday, Sunday

Shift: Office Day

Insurance Benefits: Medical, Dental, Life, Long-term Disability

Other Benefits: Employee Assistance Program (EAP), Flexible  Spending Account (FSA), ORCA card subsidy, Paid Time Off (34 days per  year), Retirement Plan

Please include in your application a cover letter that includes a  statement regarding your interest in the role as well as DESC as an  agency.

About DESC:
DESC (Downtown Emergency Service Center) is a nonprofit organization  working to help people with the complex needs of homelessness, substance  use disorders, and serious mental illness achieve their highest  potential for health and well-being through comprehensive services,  treatment, and housing. Our vision is a community where no person is  abandoned, ignored, or experiencing homelessness.
 

As the region's leading provider of services to multiply disabled adults  who have experienced chronic homelessness, DESC serves almost 2,000  people each day. Our integrated service model is designed to help people  secure and maintain appropriate, safe and affordable housing. DESC is  recognized nationally and regionally as an innovator in developing  solutions to homelessness.

JOB DEFINITION:

The Senior Medical Director is a member of the senior leadership  team of DESC, oversees the psychiatric and other medical services  provided by DESC medical personnel, and coordinates with partner  organizations to bring additional healthcare services to DESC clients.   The Senior Medical Director is a physician, board certified in  psychiatry, who provides some direct clinical care to DESC clients.   Management responsibilities include oversight of a team comprised of  more than 40 personnel (as of March 2023) including nurses, nurse  practitioners, doctors, and others. This position directly supervises  the Director of Nursing, any other Medical Directors and other  physicians, and indirectly supervises all other DESC medical personnel.   This position has administrative duties associated with planning,  hiring, and quality assurance/improvement, represents the organization  externally, participates in leadership and management of the  organization overall, and organizes and collaborates with other health  system partners.  Additional activities include engagement on behalf of  DESC in related healthcare and public health system policy work, and  leadership support and/or direct involvement in DESC evaluation and  other research efforts.

The range of DESC-operated behavioral health services includes: 

• Outpatient mental health services for 1,200+ people with serious and persistent mental illness
• One high-fidelity Program for Assertive Community Treatment team
• Outpatient substance use disorder treatment
• Street outreach and engagement services for people with untreated serious psychiatric conditions
• Low-barrier buprenorphine induction and maintenance
• 20-bed short-term shelter program for people discharged from psychiatric hospitalization
• Multi-program Crisis Solutions Center providing mobile crisis  teams, licensed 16-bed residential treatment facility to divert people  in crisis from jails and hospitals, and step-down 30-bed facility
• Additional multi-disciplinary pre-crisis and post-crisis intensive support teams
• Overdose response including OD reversals and follow-up stabilization services

Additionally, many DESC behavioral health program clients live in  DESC-operated permanent supportive housing (~1,600 units) or emergency  shelter/emergency housing programs (~380 beds).  DESC doctors, nurses,  and mental health case managers visit clients in these facilities, and  some DESC mental health case managers are fully sited in those  locations.    Clients living in DESC-operated permanent supportive housing or  emergency shelter/emergency housing programs, whether or not enrolled in  DESC’s behavioral health services, express a wide range of health  conditions and needs. Physicians and nurses from partner organizations  such as Harborview Medical Center and Neighborcare Health are also sited  in various DESC locations.  DESC medical staff collaborate with these  partner clinicians to serve shared clients.    DESC also partners with Harborview Medical Center to jointly  operate the Clinic at Hobson Place, an integrated physical and  behavioral health clinic located in a DESC property but open to the  broader community.  

MAJOR DUTIES AND RESPONSIBILITIES:   

Administration, Planning, and Supervision 

• In coordination with the Executive Director, Clinical Programs  Director, and other senior directors, assume responsibility for the  planning, implementation, operation and evaluation of behavioral health  medical services at DESC
• Develop a vision for the future of medical services at DESC and  contribute to planning efforts to ensure the availability of robust  medical services that meet the needs of DESC clients
• Collaborate closely with Clinical Programs Director and other  relevant directors and managers on budgeting, finance, and compliance  activities
• Oversee the recruitment, selection, orientation, deployment,  supervision, professional development and evaluation of all medical  staff
• Oversee and participate in credentialing reviews of contracted providers of medical services
• Establish and maintain high quality practice standards for all medical staff
• Supervise and evaluate assigned staff, encompassing clinical performance, work efficiency and output, and team collaboration
• In coordination with other relevant staff, oversee development of  operating procedures and duties for medical staff, and the development  and enforcement of program rules and practices for client and staff  safety
• Ensure that medical services comply with agency, funder, State, and Federal regulations
• Assume responsibility for the maintenance of standards of medical  services quality as defined in Washington Administrative Code and other  applicable guidelines and contracts
• Establish and ensure the efficient and equitable scheduling of clients for initial treatment and follow-up treatment
• Ensure the timely investigation and follow-up of extraordinary incidents
• Participate in planning and coordination activities of management  team; provide information to that team about issues in areas of  responsibility
• Participate in planning and implementation of integration of  behavioral health and physical health, including efforts to reduce  health disparities and improve health equity for DESC clients
• Preside over medical staff meetings, including discussion of  complex cases, clinical performance standards, literature reviews, and  general information sharing
• Represent the agency and program on community and health system committees, work groups and task forces
• Advise the Executive Director and Clinical Programs Director  regarding clinical program planning, matters of regulatory compliance  for medical staff, and other issues relating to delivery, and  integration of, psychiatric and other healthcare services
• Ensure participation by appropriate medical department staff in the Quality Assurance/ Quality Improvement Committee
• Ensure participation by appropriate medical department staff in developing proposals for on-going and new funding
• Develop and maintain collaborative relationships with internal and  external parties, including partner agencies, funders and relevant other  entities
• Maintain sensitivity to needs/goals/objectives of communities in  which programs are located, balanced with the needs and interests of  DESC clients
• Participate in a range of advocacy activity
• Other duties as assigned

Clinical 

• Practice as a licensed physician by diagnosing, analyzing, and treating complex conditions
• Review clients’ DESC charts, obtain medical histories from relevant  DESC staff and other providers and record medical histories and  diagnoses in DESC chart
• Conduct annual diagnostic reviews in concert with clinicians from other disciplines to ensure accurate diagnosis
• Collaborate with clinical and program managers for clinical  services and supervision of all patient care disciplines; Continually  work with staff at all levels to assure high quality clinical care to  clients
• Treat clients’ disorders through prescribing medication and/or  recommending rehabilitation services provided by other clinical staff
• Coordinate client care with an interdisciplinary team of social  workers/case managers, substance use disorder professionals, nurses,  mental health staff, and others
• Evaluate clients in crisis and advise course of treatment. Recommend and coordinate crisis prevention with primary therapy
• Respond to emergency situations as needed
• Conduct initial and follow-up visits in accordance with reasonable standards of care
• Evaluate client conditions for needed referrals or consultations  with other practitioners.  When appropriate, refer clients to other  specialists

Other 

• Serve as a medical liaison to community physicians, hospitals, and other providers
• Provide consultation to treatment teams
• Provide education to clinical teams/other agency staff and individually as opportunity and need presents
• Provide in-service education to physicians and medical service  staff at all levels. Works with quality assurance and others to verify  compliance with administrative rules such as and not limited to patient  and records privacy
• Participate in research and program evaluation activities,  including review of proposals to conduct research at DESC, participation  on research teams, and leadership of design and implementation of  research projects
• Demonstrate the ability to work effectively under supervision, as  part of a multi-disciplinary team, and independently, when necessary
• Take initiative to meet the changing needs of DESC’s client population, including pursuit of additional medical services
• Oversee agency response to public health events such as the COVID-19 pandemic and other disease outbreaks
• Document all client contacts and pertinent information according to  agency, County, and State requirements within stated timelines
• Provide treatment in compliance with relevant HCA policies and  procedures, WACs, Washington State RCWs, CFR, and MCO requirements

PHYSICAL DEMANDS
The  physical demands described here are representative of those that must  be met by an employee to successfully perform the essential functions of  this job. Reasonable accommodations may be made to enable individuals  with disabilities to perform the essential functions. While performing  the duties of this job, the employee will be required sit for long  periods of time, communicate with other persons by talking and hearing,  required to lift and carry items weighing up to 25 pounds and to operate  computer hardware systems. Specific vision abilities required by the  job include close vision, distance vision, color vision, peripheral  vision, depth perception, and the ability to adjust focus.
 
EQUAL OPPORTUNITY EMPLOYER
DESC  is committed to diversity in the workplace, and promotes equal  employment opportunities for all staff members and applicants. The  Agency will not discriminate against any employee or applicant for  employment on the basis of race, creed, color, sex, gender, sexual  orientation, age, national origin, caste, marital status, or the  presence of any sensory, mental or physical disability in any employment  practice, unless based on a bona fide occupational qualification.  Minorities and veterans are encouraged to apply.

MINIMUM QUALIFICATIONS: 

• Licensed to practice medicine in the State of Washington
• Board certification in psychiatry
• Certification in addiction medicine a plus
• Registration with the Drug Enforcement Agency including buprenorphine waiver
• A minimum of three years of operational leadership experience
• Specific training in research of health services or other public health disciplines a plus 
• Experience as principal investigator of funded research a plus
• Publication of research papers in scientific journals a plus
• Experience in health system policy planning and implementation a plus
• Ability to relate to a wide range of people, demonstration of  highly developed communication skills, and a desire to serve people with  complex needs who are or have been experiencing homeless and are living  with serious and persistent mental illness, other behavioral health  disabilities, and other complex medical conditions
• Solid grounding in harm reduction, trauma-informed care, health care integration, and equity and social justice principles
• Ability and interest in providing case consultations with a multi-disciplinary staff
• Ability to remain open and receptive to constructive feedback
• Ability to communicate and work effectively with staff from various backgrounds
• Subscription to the value of cooperation and continuity across programs and of consideration and respect for clients

IMPORTANT SKILLS:

• Strong oral and written communication skills
• Effective interpersonal skills
• Ability to analyze complex policies and procedures and apply them to services delivered in program
• Ability to prioritize and to shift focus rapidly to address the spectrum of issues which occur in a typical day
• Ability to balance service values with financial limitations
• Ability to communicate and work effectively with staff from variety  of backgrounds, supervise others, exercise independent judgment and  promote teamwork
• Ability to facilitate meetings and the growth of program staff
• Ability to use personal computer and learn new software as needed
• Strong understanding of budgeting processes and management of budgets
• Public speaking
• Ability to develop and analyze contracts
• Understanding of clinical best practices relevant to DESC client population