About the jobThe Collaborating/Supervising Physician provides clinical oversight, delegation of medical services, and consultative support for Vynca's Advanced Practice Providers (APPs) delivering home-based palliative and serious illness care to adult and pediatric patients across California's western region. The physician serves as the supervising physician for nurse practitioners practicing under standardized procedures under a practice agreement. The physician may supervise up to four NPs at one time. The physician remains responsible for ensuring that delegated medical services are clinically appropriate, properly documented, and compliant with California law and the rules of the Medical Board of California or Osteopathic Medical Board of California, and the Board of Registered Nursing.
What you'll doClinical Oversight and Delegation
- Serve as supervising physician for up to four NPs at one time, within the scope of your own specialty and training in palliative and primary care.
- Coordinates with Vynca to establish, review, and maintain written nurse protocol agreements for each nurse practitioner, and ensure agreements and amendments are filed with the Medical Board within required timelines.
- Be immediately available for consultation during care delivery, or designate a qualified backup physician who concurs with the terms of the applicable agreements.
- Be available to attend IDT at least monthly for one hour but may be up to one hour weekly.
Chart Review and Quality Monitoring
- Review and countersign patient records as required by the standardized procedures and practice agreements, including records for patients for whom an APP furnishes controlled substances.
- Review 100% of patient records involving an adverse outcome within 30 days of discovery, per Vynca program standard.
- Review a sample of at least 10% of all other patient records quarterly, per Vynca program standard and the method of review defined in each standardized procedure and practice agreement.
- Conduct medical record review and meetings with APRN at least quarterly to monitor quality of care.
- May require direct observation of each APP's practice, virtually. Method and frequency for auditing clinical records will be defined as per practice agreement.
Palliative and Serious Illness Scope
- Support symptom management, advance care planning, and goals-of-care conversations aligned with the Vynca model of more quality days at home.
- Where clinically appropriate and permitted under California law (including the Health & Safety Code provisions on death pronouncement and death certificates), delegate authority to pronounce death and complete death certificates through the applicable standardized procedure or practice agreement.
- Provide guidance on controlled substance management within the limits of California law for NP furnishing, including patient-specific protocols, risk assessment, patient counseling, required CURES consultation, and naloxone offering and co-prescribing requirements.
Compliance and Program Integrity
- Maintain your principal place of practice in California.
- Support continuity of oversight during physician transitions, including prompt updates to standardized procedures and practice agreements when supervising physicians change.
- Participate in Vynca clinical governance, case review, and quality improvement activities as directed by the Chief Medical Officer.
Your experience and qualifications- Active, unrestricted California medical license (MD or DO) in good standing. Willing and able to obtain additional licensure as needed. Additional licensure in WA, OR, UT, and ID, highly preferred.
- Active DEA registration.
- Principal medical practice location within the State of California.
- Board certification in Family Medicine, or Internal Medicine and Pediatrics.
- Demonstrated experience supervising or collaborating with advanced practice providers, ideally in home-based or serious illness care.
- Familiarity with value-based care and with California supervision requirements for NPs.
Compensation- Monthly stipend range of $700-$800, per APP supervised, with a $150/hr rate for IDT meeting participation. Pay for this position will be based on several factors, including, but not limited to: your prior experience and skills related to the position, geographic location, company needs, and current market demands.
Additional Information- The hiring process for this role may consist of applying, followed by a phone screen, online assessment(s), interview(s), an offer, and background/reference checks.
- Job Description Scope: This job description is not exhaustive and may include additional activities, duties, and responsibilities not listed herein.
