Job Type

Description

Shift:  

Until ORCA Center's opening (anticipated in March 2025):   

Monday - Friday, 8:30 am - 5:00 pm; including two full days of clinical care on DESC's Opioid Treatment Network team.   

Once ORCA Center begins clinical services: 

One 12.5 hour ORCA Center-based day shift (~8 am - 8:30 pm, Wednesdays preferred), one 6.5 hour post-ORCA patient follow-up clinical shift, and three x 6.5 hours on-site shifts for administrative tasks and clinical supervision (time flexible) 

Days Off: Saturday, Sunday 

Supervised by: DESC Agency Medical Director 

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 

Come work for us!

The Downtown Emergency Service Center (DESC) is currently recruiting a Senior Medical Lead for one of DESC's newest clinical programs, the Opioid Recovery and Care Access (ORCA) Center. The ORCA Center is estimated to start clinical services in mid-2025 (though the Senior Medical Lead role will start once hired) and will be open 24 hours per day, 7 days per week, including holidays. It will offer four overlapping types of services:

• Care to individuals in stable condition who have experienced an opioid overdose, brought to the ORCA Center by the Seattle Fire Department.
• Rapid initiation of medications for opioid use disorder (MOUD), including buprenorphine (sublingual and long-acting injectable) and methadone (under the "72 hour rule", or Code of Federal regulations Title 21 *1306.07 (b)), for people with OUD, regardless of whether an opioid overdose has recently occurred.
• Harm reduction counseling and OUD-related physical and behavioral health services, such as hepatitis C testing and treatment and HIV pre-exposure prophylaxis.
• Follow-up care, at the ORCA Center or at times field-based, with individuals who have started MOUD to ensure support in MOUD continuation.

DESC, together with planning partners at the UW Addictions, Drug and Alcohol Institute (UW ADAI), Seattle Fire Department, King County Behavioral Health and Recovery Division (BHRD) & Public Health, and Evergreen Treatment Services, have been engaged in planning for the ORCA Center over the last 12 months.  UW ADAI and SFD have been essential partners in the conceptualization and design of the ORCA Center and will contribute to ongoing research of the Center's impact and outcomes.  Funding for the ORCA Center has come from the City of Seattle, King County, the State of Washington, and a generous private donor. 

JOB OVERVIEW:

The Senior Medical Lead of the ORCA Center is physician, board certified in addiction medicine, who will guide the ORCA Center's clinical protocols and patient care, support the hiring and supervision of the ORCA Center's medical staff, and, together with the rest of the ORCA leadership team, be accountable for the clinical outcomes and impact of the ORCA Center.

The Senior Medical Lead will supervise roughly 5.0 FTE of nurse practitioners, will supervise and/or support two nurse supervisors (in collaboration with the DESC Senior Nurse Manager), and supervise the ORCA Center's Program Manager (who is focused on operations tasks). They will also lend support to other members of the ORCA Center, who will be directly supervised by other leaders, including nurses, certified nursing assistants or medical assistants, peer specialists, and clinical engagement specialists.

This position has administrative duties associated with planning, hiring, quality assurance/improvement, and collaboration 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. This position will interface closely with ongoing efforts at DESC to care for individuals with opioid use disorder or at risk of opioid poisonings, through a variety of harm mitigation and treatment efforts.

If you are excited about process improvement, enacting innovative and impactful addiction medicine clinical protocols, and working through implementation challenges, please keep reading!

About DESC: 

DESC is a multi-service agency that specializes in providing permanent supportive housing, emergency shelter, residential crisis services, and comprehensive behavioral health outpatient services for people with long-time experiences of homelessness and serious behavioral health disabilities. We utilize harm reduction, trauma informed care, and housing first practices, striving to deliver high-quality, outcomes-oriented, flexible services that accommodate consumers' unique needs.  The ORCA Center builds upon DESC's successful and innovative clinic- and field-based outpatient opioid use disorder treatment team and will collaborate closely with this team.   

MAJOR DUTIES AND RESPONSIBILITIES:

Administration, Planning, and Supervision

• In coordination with the Agency Medical Director, Agency Nursing Director, and other members of the ORCA Center leadership, the ORCA Program Senior Medical Lead will have responsibility for the remaining stages of planning and implementation of the ORCA Center, as well as ongoing operation and process improvement of the services, inclusive of the Center-based as well as field-based follow up care services.
• Ensure that the ORCA Center's services are adapted over time to meet the needs of the community in relation to opioid use disorders and opioid poisonings.
• Collaborate closely with the ORCA Program Manager and other relevant DESC leaders on budgeting, financial sustainability and compliance activities related to the ORCA Center.
• Oversee directly (for nurse practitioners) or indirectly or in collaboration with others (all other staff) the recruitment, hiring, orientation, training, supervision, and professional development of ORCA Center full time staff.
• Collaborate closely with the ORCA Program Manager and ORCA Center nurse supervisors in the strategic structuring, recruitment, hiring, orientation, training and supervision of a float pool of nurse practitioners and nurses to work as needed to fill gaps in ORCA Center staffing.
• Establish and maintain high quality practice standards for all ORCA Center staff.
• Supervise and evaluate assigned staff, encompassing clinical performance, work efficiency and output, and team collaboration.
• Incorporate an equity framework for all aspects of work across the ORCA Center in collaboration with other leaders.
• In collaboration with relevant staff, ensure that the ORCA Center's services comply with agency, funder, State, and Federal regulations.
• Ensure the timely investigation and follow-up of extraordinary incidents at the ORCA Center.
• Participate in DESC medical staff leadership meetings, as schedule allows.
• Collaborate with other DESC leadership staff and teams whose work interacts with the ORCA Center for enhanced client care coordination and improved client experience as they seek services from different DESC programs.
• Support ORCA Center staff meetings, including discussion of complex cases, clinical performance standards, literature reviews, and general information sharing.
• Develop and maintain collaborative relationships with internal and external parties, including partner agencies, funders and relevant other entities.
• Other duties as assigned.

Clinical

• Practice as a licensed physician by diagnosing, analyzing, and treating complex conditions, during assigned shifts. Treating opioid use disorder with buprenorphine (sublingual and long-acting injectable) and initiating methadone (under the "72 hour rule", or Code of Federal regulations Title 21 *1306.07 (b)) and caring for clients who have recently experienced an opioid use disorder but who do not need emergency department care will comprise most of the clinical care. Other common clinical areas will include treating tobacco use disorders, screening for common infections (such as HCV, HBV, HIV, other STIs), treating common infections (such as HCV, STIs), offering pre-exposure prophylaxis for HIV, discussing and offering different forms of contraception, diagnosing and treated common skin and soft tissue infection, and performing initial assessments and treatment of mental health conditions.
• Review clients' DESC charts, obtain medical histories from relevant DESC staff and other providers and record medical histories and diagnoses in DESC chart.
• Treat clients' disorders through prescribing medication and/or recommending other services provided by other clinical staff.
• Document medical care in accordance to responsible standards of care.
• Coordinate client care with an interdisciplinary team.
• 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

• Provide in-service education to ORCA Center staff at all levels. Work 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 related to the ORCA Center as capacity allows.
• Demonstrate the ability to work effectively under supervision, as part of a multi-disciplinary team, and independently, when necessary.
• Take initiative in collaboration with other ORCA leadership staff and DESC medical leadership to meet the changing needs of the community that the ORCA Center will serve, including pursuit of additional medical services. 

Requirements

MINIMUM QUALIFICATIONS:

• Licensed to practice medicine in the State of Washington.
• Board certification in addiction medicine, as well as certification in family medicine, internal medicine, or emergency medicine.
• At least one year working in a low-barrier buprenorphine program or a Federal Opioid Treatment Program. 
• Registration with the Drug Enforcement Agency.
• Initiative and creativity in designing clinical programs and clinical protocols to optimize health outcomes and best meet the needs of the patient population.
• Ability to relate to a wide range of people and a desire to serve people with complex needs who are or have been experiencing homelessness 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 to remain open and receptive to constructive feedback.
• Computer skills, including proficiency with Microsoft Word and Microsoft Excel or related experience with the indicated potential to learn these skills quickly.?
• Strong organizational and administrative skills.
• Strong ability to manage email.
• Strong ability to approach those with differing opinions with curiosity & active listening.
• Strong oral and written communication skills.

PREFERRED QUALIFICATIONS:

• Experience implementing quality improvement strategies. 
• 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 facilitate meetings and the growth of program staff.
• Experience in research or implementation science.
• Leadership experience.

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.

Salary Description