Skills & Medicine Responsibilities:
- Educate, support and care for participants receiving medication assisted treatment
- Analyze and interpret participant history, symptoms, physical findings, and/or diagnostic information to develop appropriate diagnoses
- Maintain complete and detailed records of participants' history, assessment, and health care plans
- Perform routine or annual physical examinations
- Medical examination will include the interpretation of all routine laboratory tests
- Diagnosis and treatment of illness and injury related to addiction use disorder
- Consulting with the Assistant Medical Director for treatment or referral options
- Utilization of the ASAM guidelines in directing care of participants
- Assessment of withdrawal symptoms to determine appropriate protocols and the application of those protocols
- Provides and makes self available to staff for consultation, treatment planning, and team meetings
- May provide supervision to nursing staff
- Ensures compliance with HIPAA, 42CFR regulations and all other funding mandates and licensing requirements
Clinical Service Responsibilities: Conducts and/or participates in meetings with treatment team. Participates in treatment and discharge planning for participants. Is available to staff for consultation on urgent or emergent issues. Participates in concurrent reviews and appeals as needed for participant treatment authorization.
Administrative Responsibilities: Participates in Peer Reviews to improve quality of clinical services. Provides training and consultation to treatment staff. Attends required training and meetings. May supervise licensed vocational nurses or licensed psychiatric technicians. If providing supervision, responsible for all performance management including, performance improvement plans, formal written warning notices and terminations of all direct reports as needed and in consultation with Assistant Medical Director and/or Managing Director.
Compliance Responsibilities: Compliance responsibilities include co-signing treatment plans and medical necessity determinations as required by funder requirements. Understands and ensures compliance with policies and procedures to manage risk. Ensures compliance with HIPAA, 42CFR regulations and all other funding mandates and licensing requirements. Ensures program staff, management, and other senior management are informed on quality of care concerns through regular reporting and/or team discussions.
Training Responsibilities: Training responsibilities include developing and conducting trainings in clinical topics related to the delivery of medication services. Ensures all direct reports are properly trained and updated on HIPAA regulations and compliance as well as any other ongoing compliance and regulatory requirements.
Documentation Responsibilities: Collaborates with each caseload participant and other available internal and external resources to develop/maintain treatment plans, transition plans, progress notes and appropriate updates in support of the health and recovery needs of the participant. Maintain documentation in compliance with agency, HIPAA, 42CFR, and funder standards. Properly documents all services provided and completes admission and discharge paperwork/process and required agency assessments in timely manner and ensure that the “golden thread” is documented throughout the chart. Develop and assess effectiveness of individualized treatment plans and participant progress. Maintains up-to-date files and documentation on psychiatric medications. Assist in ongoing maintenance of participants’ charts and other related documentation. Ensure that all clinical documentation is completed in a timely and accurate manner, and entered into the various electronic systems, and other duties as assigned.