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PASRR Level II Medical Director

Company: KEPRO (The Keystone Peer Review Organization), Inc
Location: Sacramento
Posted on: November 23, 2020

Job Description:

We're looking for a candidate to fill this position in an exciting company.

  • Ensures accurate PASRR evaluations through accurate clinical assessment of the patient, relevant records and collateral sources of individuals with suspected or confirmed mental illness to determine the presence of a Serious Mental Illness (SMI), as defined by 42 CFR 483.102(b)(1). Ensures accurate PASRR review completion by determining appropriate level of care based on the patient's physical, behavioral and psychological functioning.
  • Complete psychiatric aspects of the Level II evaluations with recommendations.
  • Assist QA Managers in the development, implementation and submission of the DHCS training programs developed for Level II field evaluators.
  • Assist QA Managers in the development and implementation of an ongoing QI process, attend and participate in QI Committee meetings, and review evaluations per the DHCS approved QI Monitors.
  • Conduct a quality review for each completed Level II evaluations and certify the Level II evaluation prior to submission to the DHCS.
  • Ensures compliance with necessary workflow including re-review of records.
  • Respond to state inquiries regarding evaluations conducted.
  • Attend and actively participate in staff meetings, Quarterly meetings with DHCS and conduct case consultations/peer reviews/internal auditing.
  • Review current literature, regulations and research related to long term care, mental illness, medical conditions and geriatrics.
  • Provides oversight feedback and training for evaluators as needed to ensure Level II evaluations are completed appropriately and evaluate effectiveness of the training.
  • Create, establish and chair a QI committee that reports on all QI activities.
  • Possess current, unrestricted California licenses for the practice of medicine as determined by the California Board of Medical Quality Assurance or the Board of Osteopathic Examiners.
  • Graduate of Accredited Medical School with an MD or D.O.
  • Knowledge of Federal Regulation 42 CFR, Chapter 483.
  • Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual in use in California.
  • Knowledge of standards of practice related to determination of Level of Care.
  • Knowledge of standards of practice related to mental health, geriatric and other disorders typically requiring long term care placement.
  • Knowledge and understanding of public sector services and supports.
  • Computer proficiency in Microsoft Excel, Word and Outlook.
  • Ability to determine a clinical diagnosis accounting for medical, Psychiatric, psychological and behavioral issues.
  • Ability to utilize computer equipment and web based software to conduct work.
  • Ability to interact with various office staff as needed to support necessary workflows.
  • Ability to interact with healthcare professionals, patients, their families and other supports.
  • Ability to communicate effectively to individuals and groups through spoken, written and electronic media.
  • Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.
  • Develops level of care recommendations based upon clinical evaluations.
  • Clinical and administrative functions having taught, trained or supervised others performing psychiatric evaluations within the past ten (10) years.
  • Experience with geriatric population.
  • Knowledge of an/or experience with public mental health and medi-cal programs.

Keywords: KEPRO (The Keystone Peer Review Organization), Inc, Sacramento , PASRR Level II Medical Director, Executive , Sacramento, California

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