Regional Director Clinical Operations

Professional Case Management•Paducah, KY

3d•$90,100 - $134,800•Hybrid

About The Position

Put your talents to work at PCM! Whether you work in our Home Care, Clinical Research, Impairments, or Catastrophic Care division, you will support our mission to deliver care and other services that enhance the quality of life of our clients. Be a part of our dynamic client-focused team and make a difference in your career! Responsible for leading the region’s health services and respective clinical leaders. manages, supervises, coordinates, evaluates, and develops client care teams to ensure quality care delivery and appropriate case management within the Company’s scope of services and policies; state, federal, and local laws; and Nurse Practice Act. The Regional Director of Clinical Operations shall be available at all times during operating hours and participate in all activities relevant to the professional clinical services furnished, including the development of qualifications and the assignment of personnel. The RD may be required to travel to assigned outlying regions and client sites.

Requirements

Graduate of a state-approved school of professional nursing
Current unblemished and unrestricted license as a Registered Nurse in the state(s) of practice
Minimum of five (5) years nursing experience including home care or closely related service
Complies with accepted professional standards and practice
Excellent communication (verbal and written), interpersonal and leadership skills, and strong business acumen.
Demonstrates organizational, facilitative and assertiveness skills, flexibility and the ability to work effectively in teams.
Strong analytical skills and ability to summarize and present data and statistics.
Knowledge of home care federal and state regulations
Knowledge of reimbursement sources and documentation requirements within home health care
Must be a licensed driver with automobile insured in accordance with Company and state requirements
Current CPR certification
Ability to travel

Nice To Haves

BSN or MSN preferred
Minimum of three (3) years of management experience preferred
One to two (1-2) years case management experience preferred

Responsibilities

Independently Manage and direct a team of Nurse Case Managers ensuring safe, effective, and appropriate home care services.
Oversee the management and fiscal affairs for the assigned region.
Coordinate and ensure performance improvement activities for assigned regions and is a member of the performance improvement committee.
Recommend region-specific performance improvement activities indicated from review of occurrences and others performance indicators.
Report complaints and grievances, occurrences, and infections per Company policy.
Review Company policies and procedures and recommend changes or revisions as needed and disseminate policy changes to assigned personnel
Receive client referrals, determine services required and Agency’s ability to meet those requirements.
Assign appropriate clinical personnel to clients.
Meet with case managers/clinical personnel on a regular basis to provide guidance, information related to specific issues, and education.
Provide direction to teams to ensure that client needs are met and services are provided according to the plan of care.
Assure supplies and equipment are available and maintained in working order.
Assist clinical personnel in establishing priorities, setting goals, and evaluating progress toward goals.
Attend case conferences and other clinical meetings to facilitate coordination of care as indicated.
Collaborate with administration to establish departmental priorities and budgetary needs.
Keep any local contracts current.
Review productivity of clinical personnel monthly.
Ensure 24-hour coverage by registered nurses and evaluates quality of on-call services.
Develop working relationships with other health care professionals in the community in order to identify resources available and to ensure access to client information
Provide support and direction to clinical personnel, other health care professionals, contractors, volunteers, clients, and families related to appropriate and available health care resources.
Educate and assure staff, contractors and volunteers comply with clinical services, policies, and procedures.
Coordinate provision of continuing education programs.
Facilitate problem-solving sessions to enable case managers and other personnel to resolve client and/or reimbursement source issues.
Stay current on available community resources, health care costs, and industry trends through self-education and access to outside educational opportunities.
Ensure accuracy, completeness, and timeliness of agency and clinical documentation in accordance with policies and procedures, regulatory requirements, and industry standards.
Monitor clinical records of open and closed cases regularly, and participates in quarterly clinical record review.
Provide leadership to team and support staff in identifying /client needs and opportunities for quality improvement.
Assist with marketing, public relations, and discharge planning by participating in departmental meetings.
Assist performance improvement teams with data collection and other activities performed as part of the annual performance improvement plan.
Review data to ensure accuracy and consistency with requirements.
Communicate with clinicians and provide training as indicated to achieve compliance with collection and reporting timelines.
Assures personnel, contractors and volunteers are currently credentialed by the state in which they work
Identify and implement changes in clinical and/or operational practice based on the findings of the performance improvement program.
Assures current written policies and procedures are accessible to personnel, contractors and volunteers during hours of operation
Interpret and enforce human resource policies and procedures in a fair and consistent manner.
Assist in the development of personnel qualifications, and in screening and interviewing of new personnel and make hiring recommendations to human resources.
Assist in the orientation of new personnel.
Conduct timely performance evaluations in accordance with policy.
Provide on-site supervision per policy and as needed to determine staff competency and to respond to educational and developmental needs.
Follow guidelines for disciplinary actions, documenting such actions in accordance with policies and legal guidelines.
Monitor employee turnover, overtime, and absenteeism and take appropriate actions to address problems/issues.
Collaborate with human resources/staffing to ensure proper staffing of qualified, competent personnel.
Demonstrate knowledge of infection prevention and control practices by complying with policies and regulatory requirements.
Assess safety of environment and take the initiative to help prevent accidents and promote safety and a safe environment.
Recognize and respond appropriately to potentially unsafe situations.
Designate in writing an alternate to act in their absence.
Perform other duties as assigned.