Director, Clinical Admin

Opening

Full Time 40 hours Range URG 116 Program Mgmt Orthopaedics

Schedule

8 AM-4:30 PM

Responsibilities

GENERAL PURPOSE:

Under general direction and with considerable latitude for exercise of independent judgment leads the development and management of a regional joint replacement program. Acts as a liaison between the department and the affiliate hospitals to align the strategic interests and systematically unify the overall operations for the adult joint reconstruction patients. Performs duties as an administrator providing leadership, oversight and direction for the successful development and implementation of detailed operational plans. Responsible for the development, implementation, and management of CareSense platform for orthopaedic patients/surgeons across the region.

Additionally, is responsible for leading/managing the Therapy Prior Authorization and Access Center workgroups. The primary goals are to ensure timely scheduling of therapy appointments with authorization for the services provided. Responsibilities also include developing and implementing policies to support effective patient scheduling, employee satisfaction, workflow optimization, program development, and the monitoring of budgetary goals.

Responsible for data analysis, process improvements, program planning, and supporting the growth of the service line. Provides routine reports to monitor volume, expenses, quality metrics and other pertinent outcome measures.

RESPONSIBILITIES:

Adult Reconstruction:

• Plans, organizes, and directs the administrative tasks of the adult reconstruction patients through the Nurse Navigators and CareSense regionally.
• Meet with physicians and hospital leaders to develop and monitor optimal workflows and support for adult reconstruction patients and engage various departments to problem solve issues. Establishes structures and work processes that provide excellent service to our physicians and patients through collaboration with providers, nursing, and other clinical and non-clinical departments at affiliate hospitals.
• Develops policies, procedures, and metrics to establish administrative and service line expectations.
• Facilitates timely decision making to improve patient care delivery process/systems and quality of support services to meet organizational goals and objectives.
• Supports centers of excellence and establishes goals to exceed industry standard benchmarks and develops best practices.
• Develop and maintain operational workflows to support advanced certifications for joint replacement at associated hospitals.
• Support and facilitate the tracking of hospital-based quality metrics and assist with quality improvement initiatives.
• Work closely with peri-operative and CPM teams to develop and implement strategies to optimize OR utilization and late cancelations.
• Uses metrics to forecast OR volumes and align block schedules to achieve appropriate patient/surgeon OR access.
• Provides orientation, ongoing training, and education opportunities for the development of team members.
• Engages in committees both locally and regionally to provide name recognition and learn the best practices to implement .
• Provides for a safe work environment and maintains procedures, systems, and programs necessary to ensure compliance with all regulatory requirements and professional standards.
• Ensures proper education and integration for new providers into CareSense.
• Utilizes quality improvement principles in working with regional affiliates leaders to continually improve service and efficiencies.
• Assumes responsibility for special projects involving research, planning, and recommending changes; establishes timelines, activity plans and coordinates the efforts of any subordinate staff.
• Ensures a smooth and efficient experience for both physicians and patients from the time the patient is scheduled to discharge.
• Demonstrates ICARE values in each of the major responsibilities.

Therapy Services Support:

• Manage and modify the Access Center staffing model to meet the URMC quality standards and optimize patient access to care. Manage the continuum between direct person to person scheduling and electronic scheduling.
• Troubleshoot prior authorization and claim denials and modify workflows and resources to improve reimbursement for services rendered.
• Develop policies, procedures, and auditing mechanisms for standardized workflows with communication to appropriate stakeholders. Implement and continuously develop "best practice standards" focusing on maximizing the efficiency of the eRecord workflows.
• Establish and maintain optimal working relationships with Therapy Leaders/Managers to ensure optimal scheduling and authorization for the services rendered.
• Coordinate with Hospital Billing and Patient Financial Services to align prior authorization workflows with the Medical Center standards.
• Establish goals to ensure a service culture that meets the "Medicine of the Highest Order" expectations that are highly efficient and cost-effective.
• Conduct assessments to maximize operating efficiency and effectiveness. Continually review administrative functions for opportunities for process improvement. Facilitate the implementation of electronic processes that will lead to work efficiencies.
• Maintain and monitor statistics related to work volume, productivity, and other relevant factors and initiate operational adjustments as required.
• Ensure compliance with SMH and URMFG policies and NYSDOH, Joint Commission, HIPAA and other regulatory requirements.

Staff Leadership:

• Accountable for all staff
• Articulate the Department's vision for the delivery of patient care services, set relevant goals, and hold all staff accountable for service excellence.
• Ensure that staff are provided job training and professional development, performance evaluations, counseling, and action on matters of discipline, and all other human resource issues.
• Ensure clinical competency of staff through observation and evaluation to maintain best clinical practices and quality outcomes.

Marketing:

• Assists with the development of annual marketing plan, in collaboration with the marketing staff including internet strategies, consumer and physician marketing strategies, etc.
• Maintain knowledge and awareness of competitive regional environment and develop strategies to further Adult Joint Replacement service line position in the market.

Finance:

• Develops annual surgical volume projections that support operating budget and strategic plan.
• Provides cost and volume information for the service line to value analysis process, including identification of cost-effective alternatives.
• Keeps abreast of trends as they relate to financial management and adapts new developments into planning, control, and analytical processes.
• Work with regional leadership to analysis of cost/procedure, revenue by surgeon, procedure volumes, and other metrics to track & identify opportunities for improvement.
• Identifies process improvements and cost reduction/revenue enhancement initiatives.
• Analyzes and takes corrective actions on chief reports. Analyzes chief reports to identify opportunities for cost reductions, provider utilization analysis, standardization of med/surg supplies and prosthetics and development of appropriate protocols, etc. for the service line.

Clinical Portfolio Growth:

• Facilitate the development of new and expanded services such as new service lines and satellite locations for current programs.
• Plan new clinic facilities, including providing direction and guidance in facility design.

Other Duties:

• Serve on Medical Center committees to represent the Department on programmatic issues.

QUALIFICATIONS:

• Bachelor's degree in Physical Therapy, Occupational Therapy, or Nursing required
• Master's degree in Physical Therapy, Occupational Therapy, or Nursing preferred
• MBA, Master's in Healthcare Administration, or Master's in Medical Management required
• 3-5 years of relevant experience in personnel, fiscal, and resource management required
• 2 years' experience in a health care facility required
• 2-3 years' progressively responsible supervisory/management experience required
• or equivalent combination of education and experience in an allied health or nursing position required
• Strong understanding of inpatient care, ambulatory care, physician relations, and clinic operations required
• Leadership skills required
• Self-directed required
• Team and goal oriented required
• Time management and prioritization skills required
• Basic accounting, documentation and billing understanding required

.

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How To Apply

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled

Pay Range

Pay Range: $108,483 - $162,725 Annually

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.