Clinic Operations Director (Hosp. Op.) jobs in Fayetteville, NC

The Clinic Director is an Administrative position responsible for the development and oversight of programs within a particular geographic region served by Pride in North Carolina, LLC. Persons in either of these positions participate as a member of the Pride in North Carolina, LLC. Leadership Team, the primary decision-making body of the company and are responsible for various administrative and budgetary functions as well as clinical oversight of the programs within the region. They serve as a liaison and facilitate communication between the company’s programs, the local LME, outside agencies and the regional office. Additionally, they provide both administrative and clinical supervision to employees, including hiring and training. Individuals in either of these positions are expected to be on-call 24 hours a day and provide guidance in crisis situations. The Program Coordinator must meet the qualifications of a Qualified Professional and have four years of management experience.

Program Development, Management, and Regulatory Responsibilities:

• Takes measures to market the company in order to promote new and existing programs.

• Responsible for development of new programs, including meeting licensure, endorsement, monitoring, and accreditation requirements, hiring and training staff, etc.

• Monitors to ensure that program(s) and facility(ies) operate within applicable rules, regulations and standards. Ensures each program has an updated copy of the appropriate policy and procedures manual, and standards; reviews policies and procedures with staff.

• Assists with administering program policies and procedures and ensures all policy and procedure manuals are revised in a timely manner when revisions are distributed.

• Provides ongoing monitoring, assessment, and revision of programs to ensure quality services that are consistent with the mission of PRIDE IN NORTH CAROLINA, INC.

• Establishes and maintains positive working relationships with representatives of LME’s, North Carolina Division of MH/DD/SA, North Carolina DHSR, DSS’s, and other agencies.

• Stays abreast of changes and communications set forth by the state of North Carolina and Division of Medical Assistance.

• Participates in all Mental Health and State monitoring and endorsement reviews of programs, facilities and therapeutic homes.

Documentation and Information Management:

• Develops and implements a peer review system and ensures service records are reviewed at least quarterly. Monitors quality and quantity of records for completion, accuracy and appropriate maintenance in accordance with policies and Service Records Manual.

• Ensures that all data entered into the information management system is accurate, complete, and entered in a timely manner. Develops a system for regularly reviewing data in the information management system.

• Provides training to staff regarding appropriate record documentation and use of the information management system.

• Institutes a system to ensure all service notes are regularly reviewed for accuracy, use of correct format and timeliness per State and Federal Medicaid requirements as set forth in the Service Records Manual.

Fiscal Responsibilities:

• Monitors program expenditures and staffing patterns; adjusts staffing and institutes cost-cutting measures as needed. Ensures that Program Managers are trained in completing budget sheets and submitting them in the appropriate time-frame.

• Ensures all expenses are monitored and reviewed so overspending and/or unauthorized spending does not occur.

• Reviews payroll to ensure all employees are paid correctly. Compares payroll to billing to ensure staff are accurately recording their time based on the services provided.

• Reviews all billing in the information management system, ensures that all services are accounted for and billed properly.

• Generates and maintains weekly reports regarding outstanding authorizations and unpaid claims. Documents efforts to identify and address authorization and payment problems.

• Works closely with accounts receivable and billing staff to address payment and authorization issues and denials.

• Develops and implements a system to ensure all required billing elements are in place including authorization, service order, and PCP prior to providing services. Ensures that only billable services are provided.

• Conducts internal audits of services provided to identify any problem areas and make needed corrections and changes in procedures.

Clinical Responsibilities:

• Oversees the development and implementation of treatment interventions used by each program and staff (i.e. program curriculums/schedules, skills training: anger management, social skills, coping skills, symptom management, wellness and recovery skills).

• Is knowledgeable about medical necessity criteria and utilizes evidenced based practice treatment modalities based on diagnosis of individuals receiving services.

• Ensures Qualified Professionals are trained and understand mental health diagnoses, medical necessity criteria, and best practice guidelines.

• Serves as liaison within the community and with other agencies serving PRIDE consumers, and accesses needed services. Routinely seeks input from stakeholders to ascertain effectiveness of services and overall satisfaction level.

• Ensures Qualified Professionals understand utilization management and authorization processes. Reviews authorization requests to ensure they are being completed correctly and submitted in a timely manner.

• Participates in screening of new admissions. Ensures that a current authorization, approved person centered plan or plan of care, is in place and PRIDE IN NORTH CAROLINA, INC. consent forms are signed upon admission.

• Ensures effective transition planning occurs and that the discharge summary is completed in the information management system. Reviews service record before it is closed out.

• Serves as a member of Person Centered Planning team as appropriate. Ensures that recommendations are implemented and input is gathered and used to improve services.

• Ensures that essential services for the person served are coordinated with other agencies and included in the person centered plan or plan of care.

• Writes monitors, and reviews person centered plans as appropriate; periodically reviews service records to ensure that records, notes and person centered plans meet State and Medicaid standards and are entered into the information management system.

• Ensures person served and their families (or legal guardians) are involved with all decisions concerning treatment planning, service delivery and outcomes. Routinely seeks input from these stakeholders through formal surveys and/or informal conversations or feedback.

• Uses tact when discussing sensitive issues with stakeholders and persons served. Respects the culture, diversity and backgrounds of persons served and family members.

• Respects and maintains confidentiality with regard to information concerning person served, parents/guardians, and other family members. Ensure that current releases of information are maintained in the service record.

• Ensures appropriate documentation, notifications and debriefing takes place following all crisis situations. Ensures that incident reports are entered and completed in the information management system within the required time frame.

• Leads and/or participates in the Quality Assurance Committee to ensure that all services are delivered in accordance with policy. Completes corrective action report within two weeks of Quality Assurance reviews and forwards to the Corporate Office and Manager.

• Serves as a member of the PRIDE IN NORTH CAROLINA, INC. Human Rights Committee and abides by all bylaws and recommendations. Ensures that persons served and staff are aware of and follow grievance and appeal process.

Staff Training, Supervision, and Support:

• Recruits employees whose philosophy about human services is consistent with PRIDE IN NORTH CAROLINA, INC. values.

• Ensures screening of new applicants is complete and all new hire paperwork submitted to the corporate office prior new employees working.

• Ensures that all new employees receive initial orientation and pre-service training.

• Provides or coordinates pre-service and in-service training for staff. Ensures staff are current in training and monitors continued training needs. Reviews information management system to ensure staff information is entered correctly and in a timely manner.

• Coordinates a clinical supervision schedule, oversees the development and implementation of supervision plans and ensures staff receive required number of clinical supervision hours.

• Provides clinical and administrative supervision and guidance to all staff, therapeutic parents and facilities through frequent on-site visits and modeling appropriate therapeutic interventions and teaching techniques.

• Conducts regular supervisory meetings with managers and/or Qualified Professionals and maintains documentation of meetings. Ensures Managers receive ongoing training in supervisory skills, interviewing and hiring procedures, orientating new employees and PRIDE IN NORTH CAROLINA, INC. policies and procedures.

• Maintains and models professionalism at all times and abides by all aspects of the Employee Code of Conduct.

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Pride in North Carolina, LLC is an Equal Opportunity Employer

Pride in North Carolina, LLC (PRIDE) is committed to developing and promoting high quality residential and community services that provide nurturing, caring environments for adults and youth with special needs.This commitment is premised on the belief that all persons, regardless of the nature and extent of their disability, are capable of living, learning, and actively participating in their communities as productive and responsible citizens. Pride furthermore strives to maintain the dignity and worth of individuals and their families by acknowledging and respecting their needs, providing them with a support system, and working with them as equal partners. Within a spirit of collaboration and mutual respect, Pride emphasizes a partnership approach to service delivery, believing this is the most effective means of meeting the diverse treatment needs of the people we serve. Pride strives to serve as an innovative service delivery model to other public and private community agencies by actively enacting these values within the larger community.

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