Job Details
The Director of Clinical Operations is responsible for providing clinical leadership and oversight to ISNP (Institutional Special Needs Plan). The DCO works with the Texas-based market to excel in clinical operations, processes, and outcome-based metrics in an efficient and effective manner. The DCO must work with the market leaders to ensure success while adhering to CMS and TDI guidelines.
The DCO directly supervises a team that consists of Clinical Operations Managers, Administrative Assistants, Nurse Practitioners, and Registered Nurses who work together to collaborate with the skilled nursing facilities and attending physicians who see ISNP members. The mark of success for the ISNP is a seamless collaboration of care between the member s interdisciplinary team, led by the Nurse Practitioner, that results in the avoidance of unnecessary acute admissions. This role will include time in the field meetings and communicating with business and clinical leadership at the skilled nursing facilities and with the attending physicians.
- Responsible for maintaining a high measure of professionalism.
- Design, development, and implementation of strategic initiatives for Clinical Operations in the I-SNP across the Regions.
- Completes corporate-level development and support related to training, standard operating procedures, financial management, data reporting, compliance, project management, and process improvement to achieve overall organization goals.
- Participates in budget & financial management of related / assigned projects & activities.
- Coordinates financial & operational oversight for all I-SNP clinical activities.
- Supports functions such as NP/RNCC auditing, document management, Stars/HEDIS, and policies & procedures. Support compliance related to CMS and applicable external accreditation/recognition programs.
- Manages staff and completes all related HR functions, hiring, terminations, and employee evaluations.
- Through analysis of utilization metrics, develops targeted cost containment programs and specific action plans for individual physicians and skilled nursing facilities.
- Leads and participates in key organizational initiatives such as information system implementation (EMR), Utilization and Quality committee membership, and other activities as needed.
- Participates in team meetings and rounds for communication, feedback, problem-solving, staff training and development, and sharing of program results.
- Develops clinical protocols for nurse practitioners to follow to ensure practice consistency for the ISNP Program.
- Interact and communicate with attending physicians and skilled nursing facilities to establish successful working relationships for the health plan.
- Support new market development efforts with corporate nursing home leadership, facility management, and key physicians in the community.
- Perform all other duties congruent with the ISNP Plan as assigned.
Qualifications:
- The DCO MUST be licensed as both a Registered Nurse and an Advanced Practice Registered Nurse in the state of Texas.
- A minimum of five years experience in a clinical healthcare setting.
- Minimum of five years of management experience including experience developing collaborative partnerships with enterprise cross-functional teams and experience leading large organizational implementations.
- Clear, concise, and persuasive verbal and written communication.
- Must be able to positively interact with other clinicians, senior management, patients and their families, and all levels of medical and non-medical professionals.
- MUST Reside in Texas