Vp De Adminstracion Clinica

VP de Adminstracion Clinica

Regular

Exempt

Provides high level strategic leadership and management for Clinical Administration business strategies plan, operations and initiatives and assures corporate compliance for all MCS business lines. Set and achieve corporate goals through participation in decision-making and problem-solving processes, monitors work and evaluates results to ensure that departmental and organizational objectives as well as operations requirements are met and align with the needs and mission of the organization

ESSENTIAL FUNCTIONS:

• Develop, oversee, and participate in projects that ensure the cost-effectiveness of care provided by providers.
• Establish, track, and maintain comprehensive clinical orientation and yearly competency program, along with tracking, trending, and summarizing incident reports to minimize future occurrences
• Organize, direct, and integrate practices to assure continued compliance with applicable State and Federal laws governing clinical processes
• Participate and ensure Readiness related to Clinical Management audits from but not limited to, regulatory agencies, accreditation bodies and other
• Develops, reviews, and analyzes metrics and other operational reports to ensure units are achieving goals and objectives; develops and implements corrective measures as required
• Develops, manage, execute, and monitors the operational budgets and business plan, aligned with business needs, takes corrective actions as required and facility performance objectives
• Attend local and national meetings and conferences to remain current regarding issues relevant to the performance of duties
• In consultation with, and incorporating input from clinical leaders, physicians, and staff, conceive, plan and executes proactive strategic initiatives that enable the service line to continuously improve patient satisfaction, expand market segments, and respond to emerging market opportunities; participates in marketing and promotional initiatives within the service line, developing marketing campaigns, implementing programs and reporting on measured results
• Maintain an effective working and interpersonal relationship with the medical directors, administrative personnel, hospital systems, and patients to achieve maximum operational effectiveness and customer satisfaction.
• Design, implement, and oversees clinical programs and services including but not limited to Prior Authorization’s, Care Management, SNP and SSBCI Unit, Grievances and Appeals, and the Receipt and Distribution Unit utilizing evidenced based best practices to assure compliance with regulatory requirements and the fulfillment of the company’s financial goals
• Lead the development of growth strategies across all clinical service lines
• Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices
• Analyze operational procedures and recommend changes to improve effectiveness and efficiency
• Analyze education and training programs and recommend changes to improve effectiveness and efficiency
• Assures and certifies compliance with local, state, and federal laws and regulations governing employment practices and the Health Insurance Industry, including establishing policies and procedures, maintaining manuals, and providing training and enforcement of requirements
• Determines and directs implementation of programs and changes necessary to ensure attainment of corporate goals
• Supervises, monitors, trains, and evaluates its personnel to comply with his/her role as a supervisor, to assure that his/her personnel fulfill their work plan and comply with their essential functions, and that they behave in accordance with the policies, standards, norms, and procedures of the Company
• Facilitate and conduct Clinical Team meetings with a primary focus of day-to-day operations leading to the execution of the strategic plan
• Provides strategic guidance to internal and external clients on an ongoing basis; anticipates and address client needs
• Develop and implement policies and procedures as they pertain to patient care and clinical staff employment

MINIMUM REQUIREMENTS:

Education: Bachelor’s degree in Business Administration, Health Care Management, Public Health, or related field.

Experience: Nine (9) or more years of high-level experience in the Health Industry and increasingly responsible management positions. Seven (7) or more years of supervisory experience. Proven experience might be substitute with other requirements.

Certifications / Licenses: N/A

Other: Thorough knowledge of understanding operational processes, analyses, and evaluation and improvement procedures. Broad based knowledge of the entrepreneurial business environment.

Languages:
Spanish– Advanced (writing, comprehension and reading)
English– Advanced (writing, comprehension or conversational)

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