Director Ambulatory Services

This position is responsible and accountable for the delivery of nursing services for all nursing staff and clinical nursing operations, including APP’s in CCPC.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Bachelor’s Degree in Business, Health Care Administration or related field.

EXPERIENCE:

1. Five (5) years of management experience.

PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Master’s Degree in Business, Healthcare Administration, Nursing, or related field preferred. 

2. Current license to practice as a Nurse Practitioner in West Virginia or in a state of practice.

EXPERIENCE:

1. Five (5) years of management experience, preferably in the health care field.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an all-inclusive list of all responsibilities and duties.  Other duties may be assigned.

1. Participates in all planning, budgeting, policymaking, and decision making related to clinical operations involving nursing staff.

2. Develops, maintains, implements and communicates nursing policies and procedures to staff that conform to current standards of nursing practice and organizational philosophy.

3. Ensures that nursing aspects related to risk management, reimbursement, financial management, and other administrative functions are incorporated into operational systems.

4. Monitors outcomes, budget results, patient satisfaction surveys, and other indicators of nursing performance.

5. Develops a human resources plan for nursing including staffing and types of nurses needed as well as related allied health staff. Works with human resources specialist to recruit, select, orient, and train new staff.

6. Provides supervisory duties for all APP’s and nursing resources in CCPC.  Ensures the performance and productivity of all nursing staff are evaluated annually and periodically throughout the year. Advises on appropriate corrective actions and professional development opportunities.

7. Maintains high quality of care by nursing staff through continuous improvement of standards and protocols.

8. Collaborates with physicians, medical professionals, consultants, community agencies, and institutions to improve the quality of nursing services and resolve identified problems.

9. Performs competencies for APP’s and nursing resources.  Ensures all staff is trained in quality assurance/control requirements and meet these standards.

10. Stays current with state, federal, and payer regulations/requirements and updates professional standards for nursing for the medical practice appropriately.

11. Participates in strategic and operational planning to ensure quality care. Integrates the principles and values of continuous quality improvement (CQI) throughout the medical practice. Ensures that CQI efforts comply with regulatory and accreditation standards. Meets requirements related to utilization management and risk management.

12. Collaborates with Information Technology Office to ensure data systems and programs satisfactorily support CQI activities, including maintaining QI tracking systems and database.

13. Consults with clinicians, senior business managers, and QI teams on CQI activities such as chart reviews and accurate and complete documentation and coding, providing technical support and staff education as necessary.

14. Ensures the gathering and analysis of QI data from every clinical department, converts data into statistics for analysis. Provides feedback in person and via reports to departments on trends and needed corrective actions. Leads QI committee, which regularly reviews QI data and prepares annual QI report. Resolves any patient complaints related to quality of care.

15. Develops mission, goals, and budgets for the QI department. Identifies QI opportunities, recognizes QI achievements, and recommends QI plan for next year.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Primarily medical offices. Some overtime and works on an “on-call” basis. Rare contact with patients. Some external meetings with payers, regulators, and industry representatives.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Cognizant of environmental factors, infection control issues and maintains a safe environment.

SKILLS AND ABILITIES:

1. Time management and prioritizing work.

2. Human resource management of staff from recruitment through evaluation and termination.

3. Ability to utilize computerized systems to gather data, analyze results, and make recommendations.

4. Ability to developing/maintain budgets and maintaining cost-effective nursing practices.

5. Ability to effectively use application of CQI teams, quality measures, clinical guidelines, and process management initiatives.

6. Ability to consistently meet requirements of NCQA, HEDIS, and other regulators and accreditors.

7. Ability to analyze data, problem solve, and make decisions related to nursing issues.

8. Ability to communicate with all levels and departments about nursing topics.

9. Ability to make presentations before top management, public groups, and staff.

10. Ability to collaborate with senior managers to improve clinical operations.

11.

Ability to competently use Microsoft Office, including Word, PowerPoint, Excel, and EPIC.

12. Knowledge of nursing principles, practices, and procedures.

13. Knowledge of federal, state, and payer regulations and requirements related to nursing including patient safety, infection control, and confidentiality.

14. Knowledge of medical terminology.

15. Knowledge of quality assurance, risk management, utilization management, and outcomes management standards.

16. Knowledge of QI philosophy, models, processes, and tools and their use in a health care setting. Familiarity with ways to maintain currency with state-of-the-art QI and regulatory trends.

17. Knowledge of National Committee for Quality Assurance (NCQA) structure and standards, Healthplan Employer Data and Information Set (HEDIS) requirements, and any accreditation standards.