Member Services Director jobs in Baton Rouge, LA

Member Services Director directs and coordinates all aspects of the health maintenance organization (HMO) member services department. Plans and directs policies and objectives for addressing member inquiries. Being a Member Services Director establishes service quality goals for the department and implements strategies to meet these goals. Typically requires a bachelor's degree. Additionally, Member Services Director typically reports to top management. The Member Services Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Member Services Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)

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Director of Clinical Services
  • FOUNDATION HEALTH SERVICES GROUP
  • Baton Rouge, LA OTHER
  • Job Details

    Job Location:    Foundation Health Services, Inc. - Baton Rouge, LA
    Salary Range:    Undisclosed

    Description

    Position Summary

    The Director of Clinical Services supports the Chief Operating Officer in providing support for al clinical functions at assigned facilities to ensure all client facilities operate in compliance with current federal, state, and local standards, guidelines and regulations that govern individual facilities; and in accordance with policies and procedures as may be promulgated from time to time; and as otherwise directed to promote the highest degree of quality resident care at all times.

     

    Position Responsibilities

    The Director of Clinical Services provides oversight, guidance and advice and support, evaluation and remediation, and training and follow-up to appropriate staff at assigned facilities and nurse consultants in the areas of survey process, resident assessment, nursing documentation, medication management, nursing budgeting process to include staffing levels and calculation and monitoring of nursing hours per patient day, infection control, restraint reduction, weight variances, safety, fall prevention, quality assurance, PPS (Medicare(, pressure ulcer prevention, and care planning in conjunction with the executing management team as it relates to frail geriatric residents and patients in the long-term care industry.   Responsibilities of the Director of Clinical Services include (but are not limited to): 

    • Promotes and maintains a focus of patient-centered care
    • Adheres to laws, rules & regulations and practices ethical integrity and interpersonal skills
    • Maintains compliance with long-term care regulations including federal, state and health regulations
    • Responsible to the Chief Operating Officer for the successful  development and strategical implementation of the clinical services program
    • Has strong  abilities in enforcing laws, rules & regulations, ethical integrity and interpersonal skills
    • Supervises over-all performance of assigned nurse consultants and provide orientation and on-going training programs to increase each consultant’s knowledge levels and assist each with staying abreast of changes within the healthcare arena and regulatory environment
    • Monitor trends for assigned facilities based on available information to include quality indicators, payroll variance reports, clinical indicators, 2567 reports, mock survey findings, and consultant visits. Uses such information to formulate plans for policy and procedure development, educational needs, establishes appropriate goals and approaches to address findings.
    • Conduct routine facility rounds and medical record reviews to assess quality and appropriateness of care provided and compliance with accepted nursing standards and policies and procedures.
    • Verify client facilities have working committees, including but not limited to: Infection Control, Restraint Reduction, Weight Variance, Safety, Fall Prevention, Quality Assurance, PPS (Medicare), Pressure Ulcer Prevention, and Care Planning. Assist with development of such committees as needed. 
    • Monitor facility-staffing patterns for compliance with federal and state regulations and company policies and procedures.
    • Coordinate, develop, and deliver on-going training programs for nursing services personnel at all assigned facilities
    • Monitor facility compliance with policies and procedures related to ordering equipment and supplies, related budgetary compliance, and maintaining adequate supply levels to meet resident needs.
    • Monitor facility compliance with policies and procedures related to ordering equipment and supplies, related budgetary compliance, and maintaining adequate supply levels to meet resident needs
    • Verify nursing assessments capture appropriate information to support the highest RUG level, PPD and/or case mix level for each resident
    • Provide support and education to all new facility nursing services personnel to include the Director of Nursing Services, Assistant Director of Nursing Services, and MDS/Care Planning Nurses
    • Provide support and education to all new facility nursing services personnel to include the Director of Nursing Services, Assistant Director of Nursing Services, and MDS/Care Planning Nurses 
    • Prepare nursing status reports for each facility as required
    • Function as Director of Nursing Services as required
    • Function as Nurse Consultant in areas without a Nurse Consultant as required
    • Perform position duties in a manner as to assure resident safety and rights are priority
    • Adheres to the facility corporate compliance program and promotes the program in a positive and effective manner
    • Performs other position-related duties as assigned, depending on assignment/shift setting

     

    Other Responsibilities

    • Follows facility OSHA safety rules and procedures
    • Follows facility policies and procedures and adheres to federal and state regulations for long-term care
    • Respects cultural and religious practices of patients
    • Upholds HIPAA regulations
    • Maintains a punctual and dependable attendance record

     

    Position Requirements

    • Bachelor of Science Degree in Nursing (BSN) from an NLN accredited college or five (5) years of long-term care nursing experience
    • Prior nursing experience preferable in Long Term Care 
    • Unencumbered license as a Registered Nurse in all states where assigned in good standing
    • Federal, State, and MHI required credentials current and on file
    • Cognitive skills as related to the position

     

    Working Conditions

    Because the nursing home provides round-the clock care, working hours may include days, nights, weekends and holidays.  The Director of Clinical Services works in a climate controlled and well-lighted environment with a smoke-free policy.  Works in an office and walks throughout the building daily.  Has a low risk of exposure to infectious diseases, but receives training in handwashing practices and has access to personal protective equipment if direct exposure is anticipated.  Is subject to interruptions, noise, and odors daily.  

     

    Physical Demands

    • Long periods of sitting at a desk and working on computer.  Prolonged periods of standing, bending, and reaching
    • Lifting and carrying continuously.  The ability to lift up to twenty (20) pounds occasionally.  Assistance in moving, lifting or transferring of patients may involve lifting of up to fifty (50) pounds occasionally.  
    • Fine motor skills
    • Visual acuity

    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.  While performing the duties of this job, the employee is regularly required to stand and talk or hear.  The employee is frequently required to walk; use hands to finger, handle, or feel; and reach forward with hands and arms.  The employee is occasionally required to sit and stoop, kneel, or crouch.  The employee must occasionally lift and/or move up to 20 pounds and occasionally lift or move 50 pounds.  Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.  

    Physical Demand Ratings are an estimate of the overall strength requirements that are consider to be important for an average, successful work performance of a specific job. The overall physical demand rating for a Director of Clinical Services falls within the medium classification (10 to 20 pounds of force occasionally and/or exerting 20 to 50 pounds of force occasionally.  Physical Demand requirements are in excess of those for Light Work.


  • 17 Days Ago

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Social Services Director
  • WHITE OAK POST ACUTE CARE
  • Baton Rouge, LA FULL_TIME
  • White Oak Post Acute Care has an opening for a Social Services Director. The Director of Social Services assumes administrative authority and accountability for the provision of medically related soci...
  • 2 Days Ago

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Director of Financial Services
  • State of Louisiana
  • Baton Rouge, LA OTHER
  • Baton Rouge Community College (BRCC) seeks to fill the position of Business Instructor. The Director of Financial Services. This is a full-time position. REPORTS TO:VCASA COMPENSATION: Anticipated sta...
  • 21 Days Ago

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Director, Client Services
  • Impact Solutions Inc
  • Baton Rouge, LA FULL_TIME
  • We are seeking an experienced candidate to join our client's leadership team. The client is a growing and long-standing marketing agency and the Director of Client Services role is a critical part of ...
  • 21 Days Ago

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Assistant Director of Nursing Services
  • Gonzales Healthcare Center
  • Gonzales, LA FULL_TIME
  • :NEW Sign-on for FT, qualified applicants $5000LPN or RN needed for role.Starting Rate:$28 / hr. based on experience for LPN$32 / hr.based on experience for RN:INDNURAsk us about our Level 1 and 2 edu...
  • 21 Days Ago

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Regional Director of Clinical Services
  • The Claiborne
  • Baton Rouge, LA FULL_TIME
  • Join us as a Regional Director of Clinical Services, overseeing and guiding our clinical team in our Mississippi/Louisiana communities to deliver exceptional care and services to residents and their f...
  • 26 Days Ago

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0 Member Services Director jobs found in Baton Rouge, LA area

Baton Rouge (/ˌbætən ˈruːʒ/ BAT-ən ROOZH; from French bâton rouge [bɑtɔ̃ ʁuʒ] (listen), meaning 'red stick') is the capital of the U.S. state of Louisiana. Located on the eastern bank of the Mississippi River, it is the parish seat of East Baton Rouge Parish, the most populous parish in Louisiana. It is the 99th most populous city in the United States, and second-largest city in Louisiana after New Orleans. It is also the 16th most populous state capital. As of the U.S. Census Bureau's July 2017 estimate, Baton Rouge had a population of 227,549, down from 229,493 at the 2010 census. Baton Rou...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Member Services Director jobs
$125,946 to $172,673
Baton Rouge, Louisiana area prices
were up 1.2% from a year ago

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