Director of Clinical Services

Job title: Director of Clinical Services

Reports to: Vice President – Clinical Services

FLSA Classification: Exempt

Job purpose

The Director of Clinical Services leads the operations of all of Emtiro Health’s clinical services. Emtiro Health supports health systems, providers, and health plans in value-based care arrangements. This requires innovation in care delivery and in designing programs and interventions to improve care and meet contractual obligations. In collaboration with the Vice President of Clinical Operations, the Director of Clinical Services is responsible for the development and implementation of integrated clinical and care management strategies, goals and performance measures. The Director of Clinical Services is responsible for day to day operations and evaluation of all clinical services. The Director oversees all clinical service strategies, programs, processes and tools, including the supervision of program staff.

Duties and responsibilities

Clinical Services Operations

  • Accountable for and manages all aspects of clinical services, which is inclusive of, but not limited to, population health management, care management, and utilization management

  • Manages the day to day operations of all clinical services by supporting, guiding, and serving as an effective resource to ensure high-quality and efficient clinical services.

  • Responsible for the development and management of the clinical services department budget and provides oversight to ensure financial stability and sustainability.

  • Oversees effectiveness of services through continuous evaluation and improvement of workflows and processes.

  • Works in collaboration with the Director of Business Intelligence to assure the effectiveness of the care management clinical documentation system.

  • Responsible for working with team members to establish structures and processes for developing and implementing project plans, timelines and systems

    to move new initiatives forward.

  • Is an active member of the Senior Leadership Team.

Quality and Strategy

  • In collaboration with the Director of Quality and Performance Improvement, designs and implements quality and other improvement processes related to and in support of the delivery of clinical services.

  • Works collaboratively and provides critical input into the development of Emtiro Health’s clinical strategy and quality and performance plans.

  • Collaborates with the Director of Quality and Performance Improvement, to ensure all clinical programs are aligned with Emtiro Health’s quality and clinical strategies and meet the organization’s objectives including obtaining and maintaining NCQA accreditations and recognitions.

  • Assists in identifying and implementing innovative practices, systems and processes to improve the care delivery system.

Outcomes

  • Evaluates clinical, efficiency, fiscal, productivity, and quality outcomes of all clinical service lines.

  • Utilizes data to monitor service delivery and ensure that desired outcomes are being met.

Emtiro Health’s Clinical Services Representative

  • Represents all clinical service lines to payer, provider, and community partners, and other external organizations.

  • Serves as a key liaison with payers, practices, health systems, hospitals, vendors, and other organizations, as needed.

Staff Development and Supervision

  • Identifies and participates in the development of training and educational programs to assure successful implementation of clinical services and care management programs and initiatives.

  • Provides oversight and management of department activities, including staffing and associated performance.

  • Oversees care management teams, including monitoring caseload counts, staff and process.

  • Provides regular supervision, performance appraisals and professional development to program staff.

  • Participates in regular department and interdisciplinary meetings related to department functions.

  • Maintains collaborative, team relationships with peers and colleagues in order to effectively contribute to the achievement of departmental, cross-functional and organizational goals, and to help foster a positive work environment.

Qualifications

  • A minimum of 7 years of clinical experience, with at least 5 of those years being in management, is required. Experience working in care management, nursing management, managed healthcare, clinical quality improvement and/or efficiency programs strongly preferred.

  • RN with a minimum of a Bachelor’s degree in Nursing or LCSW that is in good standing with their licensure and certification board in NC. A Master’s degree in Business Administration, Health Care Administration, Public Health, or related area is highly desirable.

  • CCM Certification is required or must be obtained within 12 months from date of hire.

  • The individual must be persuasive, influential, persistent, and able to effectively lead and communicate Emtiro Health’s vision to others including physicians, clinical and nonclinical staff, to support achievement of the short and long-term goals of Emtiro Health.

  • Excellent written and verbal communication skills, including listening skills, are critical. The individual must be comfortable speaking to groups, both large and small, and individuals, presenting ideas professionally and clearly while focusing discussions on the appropriate issues.

  • Excellent project management skills are required, including demonstrated ability to develop, implement and manage results-oriented programs that achieve targeted goals.

  • Must possess excellent creative thinking, problem-solving and organizational skills and demonstrate good judgment; must be a team player, positive, flexible, and creative.

  • Must be a strategic thinker who can work to develop programs that align with organizational goals and be able to clearly communicate to network physicians and others to ensure effective execution.

  • Knowledge and experience with developing and analyzing quality, efficiency and other performance reports, along with total quality improvement strategies, approaches, techniques, tools and analytical methods, is important.

  • Must demonstrate excellent knowledge of clinical and managed care programs and initiatives within the marketplace.

  • Must bring a strong customer service orientation and experience working in a team-oriented, collaborative environment.

  • Excellent budget development and operations management skills are required.

  • Must be proficient in Microsoft Office applications, including Excel, PowerPoint and Word and have experience utilizing data and analytics software to create and interpret quality and performance reports.

Working conditions

This position will work in an office setting during normal office hours with occasional evening or weekend work. Local travel to practices, hospitals, etc. will often be expected.

Physical requirements

This position will require lifting of up to 50 lbs. with frequent standing, bending and/or sitting. Long distance walking should be expected when visiting hospitals or larger practices/clinics.

Direct reports

Yes, clinical and non-clinical staff responsible for population health functions including complex care management, transitional care management, chronic disease management, utilization management, and prevention/wellness. The number of direct reports will be determined in collaboration with the VP of Clinical Operations.

How to apply

Cover letters and resumes should be sent to info@emtirohealth.org with the subject line: Director of Clinical Services.

Brea Neri