AbsoluteCARE Medical Center & Pharmacy
Director of Clinical Operations
AbsoluteCARE Medical Center & Pharmacy, Chicago, Illinois, United States, 60290
Job Summary
This role is an important role in the care delivery model of AbsoluteCare. The Director of Clinical Operations will partner with the on-site Medical Director as a dyad leadership team to ensure that the comprehensive care center is delivering high quality care and meeting its objectives and goals. The Director of Clinical Operations will help lead a multi-disciplinary team made up of both administrative and clinical team members and is responsible for the overall daily practice operations that support our members. This position will also be responsible for implementing and monitoring programs and policies that support our mission and are in compliance with state, federal and administrative codes.
Duties and Responsibilities
Provide daily leadership and management of care center operations.
Work closely with administrative and clinical team members to ensure that members (patients) are receiving high quality care and that the staff are motivated to deliver an exceptional member experience.
Collaborate with a team of national subject matter experts (SME) within the nursing, social work, behavioral health, and nursing disciplines and service lines.
Work closely with our community care teams to ensure effective and efficient delivery of care to members outside of the Medical Center.
Together with their dyad partner (Medical Director) own the Care Center’s operational and financial performance.
Responsible for developing the care center budget and managing to the budget annually as well as explaining monthly variances and creating action plans to correct any variances.
Own the Medical Center Scorecard and ensure both performance and financial KPIs are met.
Work closely with clinical and administrative teams’ staff to manage member utilization and engagement to drive positive patient outcomes.
Responsible for office compliance and quality assurance that includes staff education, auditing, and routine monitoring as well as adherence to office policies and procedures for the following:
State or federal standards and guidelines pertaining to the medical practice, pharmacy, and corresponding licensure.
Billing, coding, and fraud waste and abuse compliance.
Financial transactions of the medical practice and pharmacy.
OSHA, infection control and staff safety (shared responsibility).
HIPAA privacy & security.
Management of liability risk.
Patient safety.
CLIA certification.
Radiology certification and radiation safety standards.
Responsible for educating staff, monitoring, reporting, and auditing the following:
Meaningful Use for an EP.
NCQA - PCMH Recognition.
PQRS, HEDIS measures and STAR measures.
Implement and evaluate policy, procedure, and program content.
Hire, orient, train, counsel, discipline, and direct support staff.
Routinely conduct quality assurance activities through reviews, meetings, reports, and observation of results, according to professional practice standards and regulatory compliance.
Evaluate and monitor program needs, identifies unmet needs and systematically addresses need for change.
Collaborate with the compliance team to ensure applicable practice, federal and state standards are met.
Maintain and manage medical and office inventory supplies to ensure appropriate par levels.
Conduct fact-finding investigation of patient and family grievances or complaints and acts as indicated within scope of authority.
Mitigate liability risk within the practice.
Prepare reports, as indicated and necessary.
Lead monthly care center team meetings and prepares agenda as well as brings in SMEs as warranted.
Direct staff participation in fire drills and disaster evacuations.
Support and lead front office and billing operations as needed.
Responsible for overseeing local recognition and rewards program for staff.
Oversee local facilities management and security of care center.
Promote AbsoluteCare’s core values and help promote and drive positive quality metrics.
Minimum Qualifications
Bachelor’s degree.
Minimum 2 years of primary care practice management experience.
3-5 years’ experience in medical office supervision and management.
2+ years of Director of Clinical Operations experience.
Clinical background is a plus (LPN, RN, NP).
Master’s degree (MBA, MHA) preferred, but not required.
Excellent critical reasoning, decision-making, and problem-solving skills to analyze situations, determine risks, and find solutions to prevent future issues and resolve recurring defects.
Strong organizational skills and attention to details to handle multiple tasks, short deadlines, frequent interruptions, and shifting priorities in support of changing company objectives.
Excellent interpersonal communication skills.
Previous experience working in healthcare or healthcare-related fields.
Experience and understanding of managed care quality metrics/HEDIS preferred.
Understanding and experience with the Patient Centered Medical Home (PCMH) and Accountable Care Organization (ACO) medical models preferred.
An understanding and an interest in improving Population Health and associated initiatives.
Previous experience using different Electronic Medical Records and experience utilizing and leveraging the reporting capabilities/technology in order to improve clinical efficiencies.
Strong understanding of financial and accounting principles.
Excellent computer skills including knowledge of Microsoft Word, PowerPoint, Excel, and different databases.
Knowledge of medical billing rules and regulations and software applications.
Excellent organizational skills, ability to multi-task, self-motivated and able to work in a fast-paced environment.
Knowledge and experience with medical billing and coding.
Direct reports
Practice Manager, Clinical Nurse Manager, Manager of BH and SDOH, Clinical Support Specialist, Member Relations Coordinator
#J-18808-Ljbffr
This role is an important role in the care delivery model of AbsoluteCare. The Director of Clinical Operations will partner with the on-site Medical Director as a dyad leadership team to ensure that the comprehensive care center is delivering high quality care and meeting its objectives and goals. The Director of Clinical Operations will help lead a multi-disciplinary team made up of both administrative and clinical team members and is responsible for the overall daily practice operations that support our members. This position will also be responsible for implementing and monitoring programs and policies that support our mission and are in compliance with state, federal and administrative codes.
Duties and Responsibilities
Provide daily leadership and management of care center operations.
Work closely with administrative and clinical team members to ensure that members (patients) are receiving high quality care and that the staff are motivated to deliver an exceptional member experience.
Collaborate with a team of national subject matter experts (SME) within the nursing, social work, behavioral health, and nursing disciplines and service lines.
Work closely with our community care teams to ensure effective and efficient delivery of care to members outside of the Medical Center.
Together with their dyad partner (Medical Director) own the Care Center’s operational and financial performance.
Responsible for developing the care center budget and managing to the budget annually as well as explaining monthly variances and creating action plans to correct any variances.
Own the Medical Center Scorecard and ensure both performance and financial KPIs are met.
Work closely with clinical and administrative teams’ staff to manage member utilization and engagement to drive positive patient outcomes.
Responsible for office compliance and quality assurance that includes staff education, auditing, and routine monitoring as well as adherence to office policies and procedures for the following:
State or federal standards and guidelines pertaining to the medical practice, pharmacy, and corresponding licensure.
Billing, coding, and fraud waste and abuse compliance.
Financial transactions of the medical practice and pharmacy.
OSHA, infection control and staff safety (shared responsibility).
HIPAA privacy & security.
Management of liability risk.
Patient safety.
CLIA certification.
Radiology certification and radiation safety standards.
Responsible for educating staff, monitoring, reporting, and auditing the following:
Meaningful Use for an EP.
NCQA - PCMH Recognition.
PQRS, HEDIS measures and STAR measures.
Implement and evaluate policy, procedure, and program content.
Hire, orient, train, counsel, discipline, and direct support staff.
Routinely conduct quality assurance activities through reviews, meetings, reports, and observation of results, according to professional practice standards and regulatory compliance.
Evaluate and monitor program needs, identifies unmet needs and systematically addresses need for change.
Collaborate with the compliance team to ensure applicable practice, federal and state standards are met.
Maintain and manage medical and office inventory supplies to ensure appropriate par levels.
Conduct fact-finding investigation of patient and family grievances or complaints and acts as indicated within scope of authority.
Mitigate liability risk within the practice.
Prepare reports, as indicated and necessary.
Lead monthly care center team meetings and prepares agenda as well as brings in SMEs as warranted.
Direct staff participation in fire drills and disaster evacuations.
Support and lead front office and billing operations as needed.
Responsible for overseeing local recognition and rewards program for staff.
Oversee local facilities management and security of care center.
Promote AbsoluteCare’s core values and help promote and drive positive quality metrics.
Minimum Qualifications
Bachelor’s degree.
Minimum 2 years of primary care practice management experience.
3-5 years’ experience in medical office supervision and management.
2+ years of Director of Clinical Operations experience.
Clinical background is a plus (LPN, RN, NP).
Master’s degree (MBA, MHA) preferred, but not required.
Excellent critical reasoning, decision-making, and problem-solving skills to analyze situations, determine risks, and find solutions to prevent future issues and resolve recurring defects.
Strong organizational skills and attention to details to handle multiple tasks, short deadlines, frequent interruptions, and shifting priorities in support of changing company objectives.
Excellent interpersonal communication skills.
Previous experience working in healthcare or healthcare-related fields.
Experience and understanding of managed care quality metrics/HEDIS preferred.
Understanding and experience with the Patient Centered Medical Home (PCMH) and Accountable Care Organization (ACO) medical models preferred.
An understanding and an interest in improving Population Health and associated initiatives.
Previous experience using different Electronic Medical Records and experience utilizing and leveraging the reporting capabilities/technology in order to improve clinical efficiencies.
Strong understanding of financial and accounting principles.
Excellent computer skills including knowledge of Microsoft Word, PowerPoint, Excel, and different databases.
Knowledge of medical billing rules and regulations and software applications.
Excellent organizational skills, ability to multi-task, self-motivated and able to work in a fast-paced environment.
Knowledge and experience with medical billing and coding.
Direct reports
Practice Manager, Clinical Nurse Manager, Manager of BH and SDOH, Clinical Support Specialist, Member Relations Coordinator
#J-18808-Ljbffr