Job description

The Director of Clinical Services is responsible for coordinating medical services to achieve excellence in clinical outcomes, patient experience, and cost containment in accordance with best practices and nationally accepted standards of care. The Director of Clinical Services will support a culture of compliance with all applicable federal and state regulations. This position works closely and collaboratively with the members of the care group and with regional leadership.

AREAS OF RESPONSIBILITY

A successful Director of Clinical Services will be able to perform these essential duties and responsibilities.

Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.

The following is a list of essential functions, which may be subject to change at any time and without notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s).

LEADERSHIP

• Demonstrates total commitment to excellence and is a catalyst for success by providing leadership, direction, and guidance to the care team as they strive to accomplish the following: o Satisfaction with all quality measures o Satisfaction of all annual well or annual care visits for improved patient outcomes and attainment of monetary incentives by the payor. o Acceptance of Hierarchical Condition Categories (HCC) for accurate Risk Adjustment Factors (RAF). o Excellence in Patient Experience Surveys
• Supports the goals, objectives, and timelines of the healthcare system, working with a sense of urgency and accuracy to ensure success.
• Successfully integrates objectives into operational practices.
• Successfully engages in multiple initiatives simultaneously and demonstrates flexibility and a willingness to help.
• Collaborate with regional leadership team to ensure care group is adequately and appropriately staffed.
• Participate in the selection, supervision, training, and evaluation of staff in coordination with regional leadership team, training team, and human resources.
• Provide leadership and direction to the care group and oversee productivity and success of assigned staff.
• Evaluate care group personnel’s productivity and performance using measurable outcomes and objectives - analytics, reports, etc.
• Service recovery - collaboration for conflict, complaint management and resolution for any concerns.
• Consistent program review with leadership to ensure right care at right time delivery of services & support to patients, families, facilities, and other healthcare partners.
• Promote effective two-way communication between employees supervised, administration and team members within the region.
• Is achievement-oriented and promotes: o Continuous education, training, and Athena Care Coaching to advance professional skill sets. o A coaching culture and participates in conference calls, TEAMS meetings, webinars, etc o Additional coaching, education, and positive reinforcement, and enlists our team talent to assist in addressing opportunities in a timely manner for optimal performance. o Assist providers to optimize outcomes by coaching for best practices including documentation, medication reconciliation, deprescribing, timely closing of notes, and hosting advanced care planning.
• Provide SC House Calls a return on investment and be a quality steward of company funds.
• Must be available during normal work hours (unless previously approved by direct supervisor). Additional hours may be required to complete normal business functions and/or projects.
• Utilize the company’s software systems and update information as required.
• Participate in coaching calls.
• Perform other duties as requested or required, in the sole discretion of SC House Calls.

COORDINATION

• Is achievement-oriented and works collaboratively and communicates effectively with:
• All resources engaged in the team-based care of each patient, including but not limited to the visiting practitioner, quality provider, specialist, cognitive behavioral therapist, dietitian, pain interventionalist, pharmacist, medical social worker, and support team including the Regional Lead Coder, Regional Director of Training and Education, Regional Staffing Coordinator, etc.
• All medical providers including pharmacists assigned to the care group related to visits, CCM utilization, quality measures, annual wellness visits, patient experience, and quality scores.
• Hospice, home health, skilled nursing and assisted living teams to develop person-centered interprofessional team coordinated plans of care.
• RVPs with an invitation to join in team coaching calls, group meetings, and 1:1 meetings as appropriate.
• Regional team by participation in dinners, gatherings, meetings, etc. to communicate goals, and values, report on the progress toward those goals, provide direction & guidance to achieve the goals and report on trends within our healthcare system and industry to promote team momentum, enthusiasm, and pride in an ever-evolving environment.
• Regional Lead Coder (RLC) - to confirm the integrity of encounters are coded and claims billed correctly.
• Case Manager to optimize schedules.
• Regional Director of Training and Education and Regional Staffing Coordinator to: Sustain a culture conveying caring, compassion, and consideration Ensure the medical record is prepped appropriately for proactive patient management.
• Facilitate proficiency in documenting patient information & timely closing of encounters.
• Schedule AWVs to be completed ASAP and within the first three quarters. Promote effective, efficient, and accurate documentation on all diagnoses, at the highest specificity, to produce the correct risk adjustment factor accurately reflecting clinical complexity and morbidity.
• Promote effective, efficient, and accurate in capturing frailty and all advanced illness.
• Schedule GAP-IN-CARE and Quality Metric visits in a timely manner Deliver appropriate medical care through medically necessary visits by the optimal resource o Advance proactive medical care and mitigation of negative outcomes by ensuring encounters as appropriate, but no less than every 60 days.
• Facilitate excellence in “Patient Experience” as reported by the assigned provider
• Provide the necessary coaching, new user or remedial training, and ongoing support.
• Communicates best practices, clinical workflows, goals, operational processes, policies and procedures, regulatory requirements, and the value of our program to the regional team.
• Works collaboratively and communicates effectively with administration, and clinical care teams through participation in the planning, development, evaluation, and maintenance of the clinical information system.
• Implement DAX for all assigned providers.

QUALITY

• Actively engages in the development, implementation, and evaluation of the healthcare system quality improvement program.
• Identifies opportunities for improvement, recommends solutions, and coordinates/participates in the development and implementation of process improvement action plans to improve efficiencies and contribute to desired outcomes.
• Resolves problems and recommends solutions through research, inquiry, and data analysis, maintaining support and tracking of issues.
• Monitor MIPs dashboards and implement necessary interventions for improved outcomes.
• Internal monitoring as requested and required to identify and address potential issues.
• Ensure visit frequency aligns with best practice, medical necessity, and person-centered care.
• Monitor, follow-up, record, and report adverse events.
• Collaborate with Directors of Quality Assurance.
• Identify and adopt excellent protocols to reduce variability across the continuum to improve quality outcomes.
• Work with care group to prevent hospitalizations through patient touches, and monitor hospitalizations that do occur and intervene accordingly.
• Monitor regional workflow dashboard and clinical buckets to ensure tasks are being completed timely.

MISSION EXPECTATIONS

• Take responsibility for own work in completing tasks. Assist others so that the resources, assistance or support is provided to achieve success in their daily work.
• Communicate, endorse, and demonstrate SC House Calls’ mission, vision and values.
• Prompt and regular attendance.
• Adhere to standards of behavior, dress code including name tag and approved uniform, personnel department and company policies.
• Attend in-services and meetings on a regular basis.
• Promote a culture of outstanding customer service at all times.
• Must be available during normal work hours (unless previously approved by direct supervisor). Additional hours may be required to complete normal business functions and/or projects.
• Must possess the ability to deal tactfully with patients, employees, management, visitors, government agencies, and the general public and maintain an open-door policy for all employees.
• Must possess the ability to make independent decisions when circumstances warrant.

WORK ENVIRONMENT

The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job:

• May be exposed to housekeeping cleaning agents and chemicals, humidity, hot equipment, and/or noise.
• May be exposed to infections, communicable diseases, odors, bloodborne pathogens, excreta and hazardous materials.

COMPLIANCE WITH POLICIES AND PROCEDURES

• Comply with all federal, state and local laws and regulations.
• Knowledge of and compliance with Patient’s Bill of Rights.
• Must be knowledgeable of Medicare guidelines, applicable laws and regulations, and SC House Calls policy and procedures.
• Adhere to SC House Calls’ Code of Conduct / Ethics.
• Must exercise a high degree of confidentiality regarding patients, personnel and the company.
• HIPAA compliant.
• Promote a culture of compliance.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions.

• Must be able to lift, reach, bend, push, pull, use repetitive hand motions, walk and carry simultaneously.
• Must be able to withstand reaching, stooping, bending, kneeling, and crouching; walking and standing for periods of time; lifting up to fifty (50) pounds.
• Must be in good general health and demonstrate emotional stability.

QUALIFICATIONS

• Licensed nurse preferred. License must be in good standing with South Carolina Board of

Nursing.

• Physician services and management experience required.
• A minimum of three (3) years experience in healthcare setting required.
• Demonstrated ability to supervise and direct professional and administrative personnel.
• Ability to read and communicate effectively.
• Strong written and verbal skills.
• Basic computer knowledge.
• Ability to manage and demonstrate effective leadership skills.
• Should demonstrate good interpersonal and communication skills under all conditions and circumstances.
• Ability to foster a cooperative work environment.
• Team player with ability to manage multiple responsibilities and demonstrate sound judgment.
• Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile that is insured in accordance with state and/or organizational requirements and is in good working order.

Job Type: Full-time

Pay: $75,000.00 - $80,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Medical specialties:

• Geriatrics
• Primary Care

Physical setting:

• Clinic

Schedule:

• Monday to Friday

Supplemental pay types:

• Bonus pay

Ability to commute/relocate:

• Hardeeville, SC 29927: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person

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