Offer Letter Standing Faculty – Clinician-Educator Professor (Date) John Doe, M.D. 123 Park Place Philadelphia, PA 12345 Dear __________: On the basis of our recent conversations, I am pleased to offer you the position of Professor of (specify department) at (specify hospital(s)) in the Standing Faculty – Clinician-Educator of the Perelman School of Medicine at the University of Pennsylvania. Your appointment is subject to approval by the appropriate Perelman School of Medicine committees, the Dean of the Perelman School of Medicine and the Provost’s Staff Conference of the University. The Faculty Affairs and Professional Development (FAPD) website, www.med.upenn.edu/fapd contains faculty policies and related information which may be helpful to you. Within our department, (insert name of faculty coordinator) is the faculty coordinator, (insert name of department coap chair) is the chair of our department committee on appointments and promotions and (insert name of department education officer) is the education officer and may also serve as a resource for you. The Perelman School of Medicine encourages new faculty who will have teaching responsibilities to complete The Digital Welcome, an online orientation that provides critical information about teaching environments, standards, and expectations, as well as how your teaching will be evaluated. When you have attained your PennKey, you will be able to access the Digital Welcome from http://www.med.upenn.edu/fapd/professional/. It is recommended that you complete the Digital Welcome within three months of your appointment. I also encourage you to attend any of the other sessions offered through the Advance program http://www.med.upenn.edu/fapd/professional/ in your role as either mentee or mentor. In addition to attaining teaching excellence, these programs provide guidance in research, scientific writing, career development and achievement, leadership and management and technology training. Announcements about these programs are also communicated through emails. You should feel free to contact FAPD about any professional development needs or suggestions. Attached you will find a statement regarding your compensation for the period (insert date). (If applicable) In support of the University’s sustainability goals and for the convenience of employees, we have replaced University paper checks with electronic payment options: Direct deposit to your bank account (Direct Deposit) and The ADP ALINE Card, with courtesy checks, (ALINE Card)1 1 While the University’s’ options for receiving payments are designed to take advantage of the benefits of electronic methods, the ADP ALINE Card with courtesy checks option enables payees to write and cash checks for the entire amount due to them. This functionally is equivalent to a ‘check only’ process but has the added benefits of being able to the use the debit card, electronic bill payment, and/or write checks for different amounts. If you prefer the ALINE Card but require assistance in completing a written check due to an accommodation for a disability or other reason, please contact the Disbursement Office- Payroll (215-898-6301 or payroll@exchange.upenn.edu). Name of Person Receiving Letter Date Page 2 The ALINE Card is automatically issued to all new employees for purposes of receiving their pay or reimbursements for travel or other business related expenses. An ALINE Card packet will be sent to you directly from ADP. The packet will contain both the ALINE Card, which can be used like any debit card, and courtesy checks, along with instructions on how to use them. Your acceptance of employment and/or completion of your employment eligibility verification (Form I-9) constitute consent to the University’s payroll methods, including the use of the ADP Aline Card. You may choose to elect Direct Deposit at any time. If your Direct Deposit election is processed in time for your first wage payment, Penn will attempt to prevent ALINE card issuance. If you receive your pay via Direct Deposit, you do not have to activate the ALINE Card, and you can cancel a previously activated card at any time. For more information on both of these options, please visit the following website: www.finance.upenn.edu/comptroller/payroll/receiving_your_pay.shtml Further, in order to demonstrate our commitment to your work and to assist you in carrying out your academic and clinical2 goals, the following arrangements are being made for you: (insert any details regarding agreements) office and/or lab space equipment technical support start-up funding moving expenses computer As we discussed, you will be expected to participate in the clinical2, educational, and research programs of the department. Your responsibilities will include (insert description). Also enclosed are the “Guidelines for the Perelman School of Medicine Faculty Mentoring Program.” In accordance with the Guidelines, you will be expected to make yourself available to faculty colleagues who may need or request your assistance as a mentor. I encourage you to review the online guide, “Shaping a Career in Academic Medicine: Guidelines for mentor/mentee conversations” at www.med.upenn.edu/mentee. (If applicable) As a member of the Perelman School of Medicine faculty conducting a clinical practice within the University of Pennsylvania Health System, you must also be a member of the Clinical Practices of the University of Pennsylvania (CPUP). Your execution of the CPUP member agreement is a condition of this offer. As a full-time Professor of (specify department) at (specify hospital(s)) you will be eligible to participate in the generous benefits package offered by the University of Pennsylvania. After your arrival, a benefits packet will be mailed to you by the Penn Benefits Center. If you have any questions about this packet, you should contact the Benefits Center at 1-888-736-6236. You should also arrange to meet with (insert name of department administrator and title) who can be reached at (insert phone number). 2 If applicable Name of Person Receiving Letter Date Page 3 (If applicable) In addition, as a CPUP member, you also will be eligible to participate in benefits offered to CPUP members, which currently include life and disability insurance. Both the University and CPUP retain the right to modify or rescind any portion of their fringe benefits packages at any time. (or) The University retains the right to modify or rescind any portion of their fringe benefits packages at any time. You will be eligible for benefits according to the terms of applicable plans, as they may exist from time to time. As a full-time University employee and CPUP2 member, you will be subject to all applicable University, Penn Medicine and CPUP2 policies, as well as policies applicable to UPHS medical staff2. These policies, which are subject to amendment from time to time, currently include, though are not limited to, “Principles of Responsible Conduct” www.upenn.edu/audit/oacp_principles.htm), “Conflict of Interest” as described in Faculty Handbook Policy II.E.10 (http://provost.upenn.edu/policies/facultyhandbook), in related policies and procedures at www.med.upenn.edu/fapd and the enclosed policies and procedures concerning patent and tangible research property (http://www.upenn.edu/almanac/volumes/v51/n22/pdf_n22/patent_policy.pdf ). You must read and sign the Participation Agreement included with the patent policy. You will not be authorized to enter into any outside contracts or agreements on behalf of the University without formal University approval for which you should apply through me. This offer is predicated on your not having entered into any type of restrictive covenant or noncompete that could interfere with your performing the services contemplated. The offer is also predicated on your not having any preexisting or anticipated conflicts of interest with respect to your proposed position at the University of Pennsylvania. If you believe you may have a restrictive covenant, non-compete or conflict of interest, please contact me to immediately discuss this matter. (If applicable) In addition to your academic review, the following must be completed prior to providing patient care at any one of the University of Pennsylvania Health System (UPHS) facilities. The Pennsylvania medical licensure and a DEA(s) registered in the State of Pennsylvania may take anywhere from three to four months to obtain, so please allow adequate time for processing. Please go to the website below and apply for your license immediately. Once the license is granted, you will then need to follow up with the state-specific DEA as described below. While your paperwork for licensure and DEA are being processed, (insert name of Medical Affairs Coordinator) will submit an application request for your credentials, privileges and health plan enrollment (as applicable) at one or more of the UPHS facilities. Once your application request has been submitted, reviewed and processed by the Office of Medical Affairs, you will receive a letter from the Application Team with instructions on the next steps in the process. In order to ensure that your credentialing, privileging and enrollment are completed in time for you to provide patient care by your requested start date, it is imperative that you follow the instructions, respond to requests, and supply the required documentation in a timely manner. It is crucial that the correct contact information is given to your Department Coordinator so you receive the mailed materials without incident. Some of the documents/information you will be asked to supply are: Name of Person Receiving Letter Date Page 4 • Copy of medical school diploma (required for Medicare enrollment) • Medical license numbers for Pennsylvania and/or New Jersey (as applicable to your UPHS practice), and DEA and CDS numbers, if applicable. • Pennsylvania medical license application (http://www.portal.state.pa.us/portal/server.pt/community/state_board_of_medicine/12512/licensure_info rmation/599413#forms) • State-specific DEA registration - The Pennsylvania Department of Health, Managed Care Division, requires that you hold a current DEA registration with a Pennsylvania address on it if you practice in that state (with the exception of Pathologists and Non-Interventional Radiologists). If you currently hold a DEA in another state, once you have a Pennsylvania medical license you should immediately either: o Apply for an additional DEA registration number for the state in which you will be practicing (Pennsylvania/New Jersey) as soon as you have a medical license in that state (https://www.deadiversion.usdoj.gov/webforms/jsp/regapps/common/newAppLogin.jsp) or o Transfer the address on your DEA current registration to the state in which you will be practicing (Pennsylvania/New Jersey) (https://www.deadiversion.usdoj.gov/webforms/jsp/regapps/common/updateLogin.jsp) • Copy of Social Security card or W-2 form. (Required for Pennsylvania Medicaid enrollment) • National Provider Identifier (NPI) Number (FOR FOREIGN CANDIDATES) This offer is contingent upon your having authorization to work and it is your responsibility to ensure that you are in compliance with U.S. Citizenship and Immigration Services (USCIS) policies. Please contact the University’s International Student and Scholar Services (ISSS) Office at (215-898-4661) or access http://global.upenn.edu/isss immediately so that any visa issues may be addressed before you join us. Appointment and payroll documentation cannot be processed until you have presented ISSS approval. If you agree with the terms of this offer, please sign below and return the signed offer to me by (insert date). Also return the signed CPUP Member Agreement2 and Patent Policy Participation Agreement. As we discussed, assuming the faculty appointment is approved as we expect, your appointment will commence as of (insert date). Please respond promptly to requests for information or documentation. Failure to do so could result in delay of your appointment and inability to participate in particular benefits programs, such as pension and long-term disability. All of us who have met you in the department are extremely enthusiastic about your coming to the University of Pennsylvania and anticipate that you will have a highly successful and enjoyable career. I personally look forward to working with you and to helping you develop your career. Sincerely, Name of Person Receiving Letter Date Page 5 _______________________________ Chair of Department I accept this offer as outlined above: _____________________________ Date cc: _____________________________ Name of Candidate Signature Department BA Attachments: Mentoring Guidelines Professional Development Teaching Requirement Patent Policy and Participation Agreement CPUP Member Agreement2