Exhibit 10-3

EXAMPLES OF POSITION DESCRIPTIONS

The following job descriptions are provided courtesy of
THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, INC.
This information was originally contained within
Community and Migrant Health Centers: Basic Information.

JOB DESCRIPTION

Job Title:	Financial Manager/Controller
Department:	Administration
Reports To:	Executive Director
Status:	Exempt

Position Description

Responsible for the overall fiscal management of the center, including grants management, general ledger and financial reporting, supervision of 3rd party billing, and the bookkeeper, general office manager, office site manager, housekeeping and maintenance staff.

Qualifications

B.S. or Masters in Business Administration or Accounting is required, but Masters is preferred (a CPA would be helpful). A minimum of three to five years experience in the following areas: budget preparation and fiscal management, experience in computer accounting programs, and grant's management supervising experience preferred.

Responsibilities

1. Preparation and supervision of all center operations and grant budgets.
   • Prepare all grant and subcontract bills.
   • Provide monthly, quarterly and annual reporting as required.
2. Supervision of bookkeeping and billing system.
   • Includes selection, installation and training for use of new software applications and hardware.
3. Coordinate required information for center auditors.
   • Prepare requested account analysis.
   • Reconcile federal grant accounts.
4. Develop and supervise purchasing system.
5. Develop and monitor systems to ensure maximum internal control of finances, including confirming bank balances; spot-checking outstanding bills; check depreciation schedules on property and equipment, and the spot-checking of receipts from MOAs.
6. Supervision of bookkeeping department; including the editing/correcting of all output from same (such as finance statemen4 trial balance, etc.).
7. Supervise general office manager and office site manager to assure timely billing, collections and write-offs of accounts receivable.
8. Responsible for overall support, maintenance and trouble shooting of computer system.
9. Responsible for selection, maintenance and training of stand-alone hardware and software utilized in grant preparation and financial reporting and occasionally word processing and other specific grant related needs.
10. Supervise housekeeping and maintenance. Request maintenance proposals and review submitted bids.
11. Develop, implement and train staff in both accounts payable and payroll procedures (including installation and set-up of software).
12. Establish interim reimbursement rates with various insurers who reimburse on a cost of services basis.
13. Review any payroll changes and authorizations.
14. Keeping abreast of new systems in order to update existing programs to improve efficiency.
15. Perform periodic cost studies -survey of fee structures, costs of services, and work methods.
16. Train bookkeeper in new or improved ways of maintaining financial records and reports.

Skills

1. Ability to plan, coordinate and supervise work of others.
2. Ability to make professional oral and written presentations.
3. Ability to deal tactfully and courteously with the public and the Board.

JOB DESCRIPTION

General

The Finance Director directs the financial management program which encompasses the coordination and synthesis of the functional activities associated with budge4 accounting and managerial-financial reporting. The program, in addition, encompasses other technical or specialty phases of financial management such as data processing, purchasing, patient registration, credi4 and insurance.

Requirements

1. A four-year degree from an accredited college or university in Business Administration (some flexibility).
2. A minimum of five years experience in the field of accounting or finance, two of which must be at the supervisory level.
3. Must be knowledgeable in computer-based medical accounting systems.
4. Must be knowledgeable in contract administration.
5. Must be knowledgeable in fund accounting.
6. Must be knowledgeable in the nature and characteristics of administration in the public service. This includes familiarity with laws, regulations and guidelines pertaining to the agency's operations.
7. Must be able to read, write and speak the English language.
8. Must be able to make clear and concise oral and written presentations.
9. Must be professional in appearance.
10. Must be able to interact with Board members, staff, subordinates, patients, and the general public.

Reports To

The Finance Director reports to the Executive Director.

Responsibilities

1. Evaluate output requirements in order to design and maintain a financial organizational chart indicating staffing requirements.
2. Keep abreast of the personnel market and make recommendations to the Executive Director regarding salary structure and working conditions.
3. Develop and maintain written procedure manuals that are consistent with the center's policies, goals, and objectives.
4. Coordinate financial procedures with other departments as necessary.
5. Select, develop and supervise a subordinate staff to assure that written procedures are followed.
6. Update job descriptions and responsibilities as changes in policies, procedures, or operations may require.
7. Evaluate performance of finance personnel and either 1) make recommendations to the Executive Director, or 2) take solitary action regarding salary adjustments, new hire, terminations and transfers (based on personnel policies).
8. Provide staff leadership and technical guidance in reviewing, analyzing, evaluating and reporting on program progress in financial terms.
9. Compare performance with operating plans and standards and report the results at appropriate intervals.
10. Summarize the results of operations and submit cost reports and/or financial statements to the Board and all funding agencies as required.
11. Identify problem areas and make recommendations to the Executive Director and the Board Finance Committee for correction.
12. Establish and maintain an in-house training and education program regarding the internal financial process.
13. Develop and maintain a good working rapport with other departments to encourage the timely flow of financial information that is to the mutual benefit of all departments. Maintain a good public relations program that best serves the facility and the community alike.
14. Represent the facility and participate in meetings as required by the Executive Director.
15. Attend conferences and other meetings as necessary to keep abreast of the economic environment.
16. Review complaints and grievances and make recommendations to the Executive Director.
17. Negotiate contracts as directed by the Executive Director.
18. Work in coordination with the Medical Director to monitor and evaluate insurance coverage and make recommendations for changes to the Executive Director if conditions indicate.
19. Other responsibilities as may be assigned by the Executive Director.

JOB DESCRIPTION

Role of the Medical Director

The Medical Director is the individual responsible for overall medical services for center patients. This person reports to the Executive Director. The Medical Director should be able to work cooperatively and effectively with the Executive Director, should utilize a balanced approach which includes the perspectives of all disciplines involved in health services, and should have a role definition which is flexible enough to accommodate the diversity of programs offered through the center.

1. Qualifications

   The Medical Director must be a physician eligible and licensed to practice medicine. The Medical Director should have a strong community health/public health orientation, be Board Certified/Board Eligible in a primary care specialty, be experienced in a rural, as well as an urban setting, be experiences in patient care management, and have an interest, as well as experience in managing major clinical activities.

2. Areas of Responsibility
   1. Planning
      1. To help develop and review with the center's Board of Directors its annual health care plan as it relates to medical services based upon the community needs -assessment demographics, disease patterns of the community and health behavior of the community.
      2. Recommend clinical objectives and participate in the designation of priority objectives for the center with reference to implementation of the health care plan.
   2. Organizing
      1. Participate in Executive Committee functions.
      2. While reflecting the need for significant subspecialization and segmentation of services and the provision of contemporary medical care, the Medical Director shall develop an organizational plan for integrating all components of the clinical system.
      3. Participate in community organization activities designed to modify community health behavior and disease patterns.
   3. Budgeting
      1. Participate in the development of the project's financial plan (budget) with ongoing monitoring and evaluation of such.
      2. Help develop and present the clinical activities budget, including staffing and equipment needs projections.
   4. Staffing
      1. Prepare and recommend qualifications statements for credentialing, and job descriptions and evaluation standards for all medical personnel.
      2. Assist in the identification of areas for physician staff additions, assist in the recruitment of physicians and the acquisition of professional staff. Prepare recommendations for hiring and firing for the review and approval of Executive Director.
      3. Serve as a primary rater (or reviewing officer where additional levels of supervision exist) for medical personnel, recommend and participate in final detern1ination of disciplinary actions and tern1inations, as well as nomination of individuals for awards.
      4. Resolve conflicts among the professional personnel.
      5. Provide input in the selection of key non-clinical personnel including the Executive Director, as prescribed by the Board.
   5. Controlling
      1. Advise on medical information systems needs; develop, recommend, and conduct special studies of operations.
      2. Interpret clinical data.
      3. Participate as appropriate in the periodic review of practice management functions, e.g. reception, telephone triage, patient flow, out reach services, laboratory, pharmacy, tracking systems.
      4. Review of patient satisfaction surveys; recommend modifications as appropriate. Review all patient complaints as they relate to clinical care.
      5. Participate in periodic management reviews by project administration.
   6. Operations
      1. Arrange and conduct regular meetings of medical providers and staff.
      2. Represent the medical department and medical personnel at Board of Directors meetings.
      3. Provide day-to-day clinical supervision of staff.
      4. Review and present Principles of Practice and Policies and Procedures for all providers, including mid-level practitioners.
      5. Institute and manage continuing and professional education in-service training and orientation of clinical staff.
      6. Participate in development of health risk management protocols.
      7. Advocate for the center and serve as liaison to (including active membership in) local hospitals, local and state professional societies, as well as to health officials, organizations, and health training institutions as appropriate.
      8. Coordinate the marketing of the group's professional services and programs.
      9. Perform or delegate patient relations tasks.
      10. Evaluate patient and community health education services.
   7. Evaluations
      1. Supervise development, implementation, and operations of the Quality Assurance Program as it relates to patient care.
      2. Present reports on health and quality assurance matters to the Executive Director and to the Board of Directors regularly and periodically, as determined by the Board.

3. Evaluation of Medical Director

   Medical Director shall establish a work plan and time table of annual priorities with the Executive Director to coincide with the review of health care plans and objectives. Whereas the successful performance of these functions obviously requires the efforts of many persons, the Medical Director may facilitate and integrate these efforts for the group and will be evaluated yearly on these efforts.

JOB DESCRIPTION

Duties and Responsibilities

Program planning, implementation and evaluation

1. Develop annual goals and objectives for medical staff
2. Set clear priorities and delegate responsibilities
3. Facilitate and oversee implementation
4. On-going trouble shooting and modifications

Supervision or medical staff

1. Responsibility for overseeing the professional conduct and practices of all medical staff (includes consultants and volunteers)
2. Development and implementation of center mid-level practitioner policy and goals as well as daily supervision and co-signing of charts

Quality assurance

The duties of medical director shall include the following. These may be carried out in conjunction with the clinic coordinator, administrative component and/or other professional staff, but are the responsibility of the medical director to oversee.

1. Establish, review, and maintain medical standards with the aim of assuring the quality of medical care provided to clinic patients.
2. This shall include reviewing professional credentials and delineating the roles and responsibilities of the medical staff. These shall be reviewed annually in conjunction with annual staff evaluation and annual clinic goals assessments.
3. Protocols used by the clinic shall be reviewed and approved by the Medical Director and/or designated medical providers committee as overseen by the Medical Director.
4. The Medical Director shall oversee the implementation of a peer review system which includes:
   • Daily wrap-up sessions,
   • Problem identification by monitoring discussions at provider meetings,
   • Patient care protocols reviews,
   • Quarterly medical chart audits - policy, goals, and implementation,
   • Cost effectiveness policy and goals, and
   • Continuing medical education (CME) policy and goals.

Internal Liaison/Coordination Activities

Initiate and facilitate communication and information flow with external health related agencies/organizations. Set goal of improving formal relationships with the more closely related groups (sample groupings).

• Executive Committee
• Administration
• Health Education
• Support Services
• Computer Committee
• Perinatal Project
• Miscellaneous Projects and/or Committees
  • Volunteers
  • Ad hoc recruitment and interview committee
  • Employee health policy enforcement

External Liaison/Coordination Activities

Initiate and promote communication and information flow with external health related agencies/organizations. Set goal of improving formal relationships with the more closely related groups.

• Community Mental Health Services
• Health Agencies
• Hospitals

General Administration

Oversee, administer, and delegate to Clinic Coordinator the following:

1. Coordination and trouble-shooting/problem-solving of the following:
   • Medical services - support services interface
   • Personnel
   • Programs
   • Procedures
2. Contracts
   • Initiate and facilitate technical/medical consultation and input for all medical service contracts
   • Monitoring and evaluation
3. Licensure
   • Initiate, facilitate, and enforce compliance with licensure regulations, policies, and procedures
   • Liaise (with Administration) with licensing agencies
4. Data Collection and Analysis
   • Initiate and facilitate data collection and analysis of overall clinic operations
   • Follow up on recommendations
   • Initiate and facilitate computerization. information management and reports

Qualifications

• Currently licensed M.D. in good standing
• Administrative and personnel experience
• Bilingual in a ( ) language
• Board eligible/Board certified in a primary care specialty
• Family Practitioner preferred

JOB DESCRIPTION

Job Summary

The Chief Executive Officer administers, implements, and directs all aspects of centers in accordance with the policies of the Board of Directors and funding agency. The CEO organizes and coordinates the functions of the satellite centers through appropriate departmentalization and delegation of duties; coordinates and integrates administrative management with the clinical aspects of the center's overall programs and presents information to the governing Board as a basis for sound decisions when rendering policy and program directives; develops/maintains effective public relations with the community, other health care institutions/providers, civic organizations, national, state/local groups.

Duties Performed

1. Implements, directs and evaluates the effectiveness of administrative management necessary to carry out the center's program(s) as described in the corporate health care plan and grant proposal.
2. Develops and formalizes project program plans/policy changes in accordance with the governance decisions of the Board of Directors and funding agency.
3. Interprets corporate policy and makes administrative decisions soliciting the input of each department and the Board; makes necessary changes/improvements in the existing administrative procedures/practices.
4. Prepares job descriptions in conjunction with the Administration Officer/department heads, recruits potential staff, orients new employees, hires, supervises/ discharges employees;
5. Develops/maintains personnel policies and procedures for the center which are subject to the approval of the Board of Directors.
6. Ensures that personnel management contributes to the maximum utilization of manpower toward efficient implementation of the center's program(s).
7. Directs the development of standards and methods used to assess the activities of the center with respect to the feasibility, quality, productivity, costs/other aspects of the center's administration.
8. Implements an effective system of financial management and control to ensure that quality health care service is being rendered in a cost effective manner; ensures that funds, personnel, equipment/supplies are utilized effectively in carrying out corporate policies and program plans.
9. Formulates and justifies the fiscal budget in accordance with limitations prescribed by the Board of Directors/funding agency(s).
10. Submits timely and accurate reports, forms to DHHS, SHO, IRS and others as required.
11. Serves as a liaison and channel of communication between the Board of Directors, its committees, clinical staff, and community.
12. Establishes and maintains relationships with other health care institutions and providers, national/state/local organizations, and disseminates pertinent information concerning the center's programs (in conjunction with Medical Director).
13. Keeps abreast of current trends and innovative programs which relate to health care administration/clinical management.
14. Performs other duties which may be assigned by the Board of Directors.

Qualifications

Education

1. Master's degree from an accredited college or university in the field of health care/business administration, or a Bachelor's degree with equivalent experience.

Experience

1. A minimum of five (5) years responsible administrative experience. Relevant experience within the framework of a non-profit multi-service health care facility or comparable (smaller) organization.

Other Requirements

1. This position requires a high degree of health administration knowledge, initiative, originality, diplomacy, visibility, and the exercise of sound and responsible judgment.
2. The CEO must have a thorough knowledge of the problems and techniques of health care delivery (in an urban/rural area). Must be capable of dealing with persons of diverse educational and cultural backgrounds.
3. Must have thorough working knowledge of federal, state, and local regulations governing the operation of a health care facility.
4. Ability to present clear, concise and comprehensive oral and written reports.
5. Ability to establish and maintain effective working relationships with federal, state, and local organizations/officials.
6. Ability to work within the community to build consensus and coalitions.

Additional Skills for Managed Care Operations
Ability to understand negotiation process/position; short- and long-term risk exposure; utilization review (UR); and Incurred But Not Reported expense (IBNR).

JOB DESCRIPTION

Introduction

The Executive Director is responsible to the center's Board of Directors for the overall program. Secondly, the Executive Director directs the administration of the program to assure meeting the health needs of the community.

Duties and Responsibilities

1. Responsible for administration and management of the overall program to assure that program objective are met.
2. Develop and work closely with Board and other key staff to develop long/short range plan for program development that will include public relations, finance and personnel.
3. Works closely with the Board of Directors, in reviewing, modifying and updating program services and plans.
4. Works with the Board of Directors and committees in the formulation of policy and is responsible for implementation of the policies adopted by the Board.
5. The Executive Director will hire the Medical Director and any department director and concur with them on all staff appointments. The Executive Director has the authority to hire and fire staff, in accordance with center policies and procedures.
6. Has total responsibility for the implementation of the health care delivery system consisting of primary care, referrals, preventive medicine, health education, marketing, patient registration, statistics, financial management and public relations program.
7. Executive Director is responsible to see that all policy changes are implemented immediately. Review and upgrade of policies by Board of Directors will occur annually.
8. Direct day-to-day progress toward goals through department directors by reviewing department reports and via meetings.
9. Assures that special reporting assignments to staff members are completed.
10. Attends and participates in regular Board, committee, and community meetings, and develops strong public relations within the communities served by the center.
11. Conducts periodic meetings with center department directors as a group and individually to determine progress and needs. Department directors should report to the Board of Directors on a quarterly basis.
12. The following reports should be submitted to the Board previous to Board meeting: Finance Committee minutes and report, a written activity report by director (monthly summary), and others as required.
13. Develop working relationships with local, state, and federal agencies to utilize all resources available. These relationships shall be written as Memorandum of Agreement (MOA) and Memorandum of Understanding (MOU) and evaluated annually by the Board.
14. Will attend staff meetings at each clinic site at least twice a year.
15. Responsible for the development and coordination of physical planning for remodeling and new construction of center facilities. Works with unit personnel, architects, state licensure and certification personnel to assure compliance with state and federal requirements.
16. Other duties as assigned by the Board of Directors.

Education and Experience

1. The Executive Director should be familiar with the needs of the (urban/rural) communities. Must possess strong leadership skills. Must understand the fiscal- programmatic administration of the developments of the health care program. Must understand the needs of the consumer and understand the complex management of a diverse community based health care program.
2. Must have a college degree and have at least three years of experience in administration and/ or supervision. Should have a strong background in health care administration and program management to include financial management in a health care organization.
3. Must have supervisory experience in the supervision of several employees and in public relations.
4. Should have a broad knowledge of all facets of health related delivery systems.
5. Should be knowledgeable in the health resources and delivery systems. Should also be sensitive to the health care issues of the multicultural population of the center area.
6. Should be experienced in recruiting medical providers and other professional staff.
7. Must have the ability to coordinate, present, and evaluate seminars and training sessions.
8. Should be fluent in the English, Asian, Spanish, etc. language.

Additional Skills for Managed Care Operations

Ability to understand negotiation process/position; short and long term risk exposure; utilization review (UR); and Incurred, But Not Reported expense (IBNR).