Come work in an environment where we truly value and respect those we serve and believe in the mission that all people can achieve a higher level of wellness and independence. The Texas State Hospitals (SH) is comprised of nine psychiatric hospitals located throughout the state and one youth residential psychiatric center in Waco. The state hospitals are a hub of excellence for forensic mental health and complex psychiatric care, with all facilities accredited by The Joint Commission. The state hospitals provide state-of-the-art treatment that is recovery-oriented and evidence-based. Your contribution will make a difference in the life of a Texan.
The State of Texas offers many benefits to employees. HHSC is a qualifying organization for the Federal Public Service Loan Forgiveness Program, which forgives the remaining balance on college student Direct Loans after making 120 qualifying monthly payments. We also offer excellent health benefits, a lifetime monthly retirement annuity as well as 401(k) and 457 Programs under the Employees Retirement System of Texas.
The Lead Psychiatrist performs highly advanced psychiatric work under direct supervision of the SH Medical Director. Directs, oversees, and/or conducts the examination and diagnoses of patients, and administers psychiatric treatment and medication as needed. Administers specialized psychiatric treatments and/or procedures. Directs staff and provides leadership to ensure optimal quality psychiatric treatment services for the individuals entrusted to the care of the SH. Monitors trends and activities, prepares reports, and makes recommendations for operational and services improvement as appropriate. Leads the patient’s recovery team and provides guidance on the treatment of the patients under their care. Reviews patient records and files in conjunction with the recovery team to determine the progress, effectiveness, and appropriateness of treatment services offered. Plans, assigns, and/or supervises the work of others, including other Psychiatrists. Participates in committees of the State Hospital Governing Body and performance improvement activities. Participate in or directs, as requested, any other clinically related committee that is formed for the SHs to recommend guidelines and standards of care in response to changes in research literature, regulatory environment, or public health as requested by the facility Medical Director or central office Chief Medical Officer. Plans, assigns, and guides the work of others in the process of the multi-disciplinary approach to patient care. Works under minimal supervision with extensive latitude for the use of initiative and independent judgment.
Performs other duties as assigned. Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location. |
Essential Job Functions:
- Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned. May serve in an on-call or on-duty status on a rotating schedule to meet operational needs of the facility.
- Utilizes a multi-disciplinary approach to complete psychiatric assessments of individuals and administers psychiatric treatments and medications within the SH policies/procedures as deliberated with and agreed upon by the The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS), Texas Administrative Code (TAC), Texas HHSC Executive Formulary Committee, and SH policies. Attends and participates in other meetings and committees as requested. Performs medication reviews in accordance with policy. Plans, assigns, and guides the work of others in the process of the multi-disciplinary approach to patient care per policies and procedures.
- Conducts psychiatric clinics as scheduled and psychiatric reviews as requested by the review team or the central office Chief Medical Officer. Treats each individual with the most effective medication and the most effective dosage. Reviews lab work, modifies recovery plans, and records deliberations and treatments accurately and timely in the electronic health record.
- Develops and implements psychiatric recovery plans documenting how supports and interventions are customized for the individuals’ psychiatric needs as well as their strengths and preferences. Documents how recovery plans are person-centered and least-restrictive interventions based on risk vs. benefit analysis and treatment history, and how psychiatric supports and interventions are integrated with the supports and interventions from other disciplines. Develops and organizes implementation timeframes and provides guidance to the recovery team and direct care staff while following HHSC and local policies and procedures, TJC standards, CMS conditions of participation, TAC, and other state statutes.
- Reads and analyzes medical records, leads discussions in staff meetings, participates in conference calls concerning clinical psychiatric issues, reviews the clinical practice of providers in peer review proceedings, and provides written opinions and recommendations as appropriate on all matters raised in these venues. Interacts with and makes recommendations to family members, guardians, and legally authorized representatives (LARs) when requested, and obtains timely medication consents.
- Ensures collaboration between psychiatry and other medical disciplines for dually diagnosed individuals. Provides other medical specialists with necessary information and ensures that psychiatry notes reflect this collaboration.
- Consults with other psychiatrists, medical staff, psychologists, and others to collaboratively develop psychiatric interventions, identify environmental factors that may impact psychiatric care, and participate in restraint reduction efforts by coordinating medication and behavior therapy. Manages acute psychiatric care including authorizing emergency restraints and writing orders for the emergency use of medication.
- Reviews and monitors system data and trends related to the quality of psychiatric care provided at the SH. Addresses issues identified through monitoring of data and presents changes to the recovery plan. Attends meetings and chairs discussions to inform and create buy-in to necessary changes and follows through on SH performance improvement plans. Participates in desk and onsite audits by reviewing records and applying audit tools.
- Maintains open and regular communication with the Medical Director, Superintendent, and other staff to ensure the transfer of needed information and continuity of services. Participates in various Medical Staff Committees and Sub-committees (Utilization Management, Infection Control, Pharmacy and Therapeutics, etc.) designed to ensure patients are receiving quality care.
- Participates in mandatory training per HHSC policies and procedures, HIPAA policies, state and federal rules and regulations, and TJC standards and CMS conditions of participations to provide quality psychiatric services and care to individuals served. Travels occasionally to other SHs to participate in team reviews to assess compliance with regulations, policies, and standards.
- Develops, implements, organizes, and provides leadership in the area of Psychiatric Services following HHSC policies and procedures, state and federal rules and regulations, and TJC standards and CMS conditions of participations in order to provide quality psychiatric services and care to individuals served.
- May review the work of other Psychiatrists and clinic staff for appropriateness of care, quality of care, and timeliness of care. May manage staff within the psychiatric department.
- Provides psychiatric coordination, collaboration, and consultation with the facility Medical Director, the central office Chief Medical Officer, central office Chief of Forensic Medicine, central office Director of Facility Operations, and central office Associate Commissioner in all matters of patient care services, quality improvement initiatives, TJC compliance, state TAC, and regulatory agency code compliances. Advises the facility Medical Director, the central office Chief Medical Officer, and central office Chief of Forensic Medicine of unusual or difficult psychiatric problems experienced at the SH.
- Stays current with research of psychiatric and behavioral health treatments. Reviews and makes recommendations to the appropriate authority for changes in evaluation tools and treatment protocols used to ensure compliance with the standards for quality of care concerning psychiatry and behavior health services.
- Provides staff guidance and training for new employees, professional staff, direct contact staff, and families. Participates in mandatory training per HHS policies and procedures, HIPAA policies, state and federal rules and regulations, to provide quality psychiatric services and care to individuals served.
- If the assigned SH supports a psychiatric residency program, may serve as a supervising physician and liaison to resolve issues related to student rotations at the SH by initiating contact with medical schools, attending meetings, and writing statements of work for contracts.
- Other duties as assigned include but are not limited to actively participating and/or serving in a supporting role to meet the agency’s obligations for disaster response and/or recovery or Continuity of Operations (COOP) activation. Such participation may require an alternate shift pattern assignment and/or location.
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Knowledge Skills Abilities:
- Knowledge of methods and procedures in the field of general medicine and general psychiatry.
- Knowledge of principles of the development, implementation, and documentation of person-centered individualized care and recovery plans.
- Knowledge of the principles of behavior treatment and ability to work collaboratively with staff.
- Knowledge of the state formulary guidelines for maximum doses, and if exceeded, provides detailed documentation of exception, ensuring efficacy, safety, and tolerance.
- Knowledge and skill in providing services to people with psychiatric disorders in an in-patient hospital setting.
- Knowledge and skill in effectively using an electronic healthcare system and Microsoft office products.
- Skill in the care and treatment of patients; in the use of medical and psychiatric diagnostic and treatment tools and equipment; and in conducting psychiatric research when necessary.
- Ability to assess, diagnose, and prescribe/supervise treatment to assigned patients while conforming to local policy, Texas Administrative Code, and applicable laws to decrease psychiatric symptoms/disorders.
- Ability to direct psychiatric activities; to examine, diagnose, and treat mental disorders; to interpret psychological diagnoses and analyses; develop policies and procedures; and to prepare and supervise the preparation of case histories and medical records.
- Ability to solve medically difficult issues by considering opinions of consultants and/or appropriate literature including accepted guidelines.
- Ability to work with the recovery team by facilitating a unified, effective team approach using the expertise of all team members in order to ensure high quality patient care.
- Ability to participate with other psychiatric staff to provide continuous quality improvement and to promote quality care by adhering to the plan of improvement and state initiatives.
- Ability to manage “polypharmacy” and to justify and document when use of multiple psychotropic medications is necessary.
- Ability to plan, assign, and/or supervise the work of others.
- Ability to work independently using good judgement and advanced time management skills.
- Ability to participate in annual training as well as any other required specific training in order to ensure up-to-date skills and knowledge in required areas such as CPR and the safe use of restraints.
- Ability to organize and present information effectively, both orally and in writing.
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