Clinical Manager

Job Description

Job Title: Clinical Performance Advisor

Location: Alamogordo, NM (onsite)

Duration: Full-Time Direct Hire

Timings: 7am/8am – 4pm/5pm (M-F) (No Night Shifts, No weekends)

About the Company:

Since its founding in 1996, CTC has grown into a trusted global partner in AI & ML, Enterprise Applications, Digital Services, Managed Services, and Business Services. With headquarters in Detroit, Michigan, CTC has a team of over 2,000 experts worldwide. We empower more than 100 organizations to tackle complex challenges and transform them into sustainable competitive strengths--driving innovation, efficiency, and growth every step of the way. Our strengths have always been Commitment to Customer, Commitment to Colleagues, and Commitment to Community (CTC).

Job Description:

The Clinical Performance Advisor EM/HM is responsible for the clinical performance oversight and on-site operational management for all facility’s programs that service the client. This position, in partnership with the Medical Director, will be the primary point of contact with the hospital, collaborating directly with the Chief Nursing Officer and other key leaders and support staff to manage clinical operations, quality, safety, patient experience, provider well-being, and provider/provider group performance. This position will be dedicated or rotating, dependent upon the needs of the client/s assigned.

Leadership Competencies:

• Strategic Orientation: Creates strategic vision and inspires team to execute effectively. Future-focused. Anticipates trends and responds proactively.
• Talent Champion: Understands team members’ career interests and encourages talent mobility across functions. Leads with humanity; is effective at both giving and receiving feedback and coaching.
• Accountability: Assumes responsibility for actions, behavior, and outcomes. Demonstrates ownership.
• Innovation & Growth: Seeks new and better ways to achieve results. Maintains a “growth mindset.”
• Results Focus: Makes decisions thoughtfully and quickly, achieves or exceeds goals, and is action oriented. Achievement-focused.

Responsibilities:

• Represent facility, patient services, and the Hospital to ensure retention of existing referral sources, grow new referrals and volumes by enhancing client, PCP, Patient and Provider Satisfaction, as well as Quality Case Management, Emergency Department, and other facility relations.
• Support training coordination and orientation process of new office staff, and all patient care providers including, but not limited to, maintaining current orientation packets, obtaining computer access and any facility specific training.
• Participate in physician interviews and coordinate with the Staffing Operations team to ensure applicants meet with the medical directors and tour all facilities of interest.
• Act as a professional representative in dealing with all levels of hospital and staff personnel and promote communication within the hospitalist team and with hospital staff, patients/families, caregivers, administration, nursing staff, referral sources, care management, and facility’s corporate team members.
• Serve in support of the Medical Director as point person and liaison for the program.
• Ensure accomplishment of organizational and program goals by maintaining and cultivating collaborative relationships with key personnel.
• Monitor onsite performance, operational challenges, and share recommended strategies for improvement and efficiencies to the VP of Clinical Performance Improvement and the Field Operations teams.
• Oversee daily practice operations and support the needs of the program related to physician engagement, facility initiatives and priorities.
• Lead and support daily workflows designed to drive clinical performance initiatives. These include, but not limited to, daily throughput/LOS workflows, MDR attendance, physician/patient rounding, provider education, data analysis and service recovery.
• Recommend and implement improvements to the practice as it relates to KPI’s, and Client & Provider Satisfaction as established by both the facility and client teams.
• In collaboration with the facility’s Field Operations team, Medical Director, establish and facilitate standing HM Committee meetings between Hospital Administration, designated facility department managers, and facility's HM representatives (include ED representatives if contract includes both).
• Facilitate engagement with Medical Director(s) to result in meeting participation, provider recruiting and retention.
• Availability by phone or pager for emergencies, patient complaints, high-risk patients or situations and all practice support functions.
• Work with hospital administration to attain the group’s key clinical and practice indicators relating to quality, core measures, readmission rates, length of stay, case mix index (CMI), billing/diagnostic coding trends, and daily volume statistics.
• Participate in organizational planning and evaluation of the program in conjunction with Medical Director and Field Operations team with collaborative communication, constructive feedback, problem solving, data analysis, operational reviews.
• Meet regularly and assist Medical Director and Field Operations team in development of clinical protocols, order sets, workflows, best practices, engagement, etc.
• Ensure completion of all site-specific requirements.
• Participate in required corporate meetings, training sessions, organizational pilot programs, and cross coverage as requested.
• Support value-based care goals and data/information sharing requirements.
• Additional duties and responsibilities as requested by VP of Clinical Performance Improvement and Field Operations team.

Qualifications:

Knowledge, Skills, and Abilities:

• Knowledge of Medicare, Medicaid, and Marketplace lines of business and applicable regulatory requirements.
• Knowledge of relevant state and federal healthcare regulations.
• Intermediate knowledge of healthcare informatics, including clinical quality measures.
• Working knowledge of staff development and the educational process, quality improvement, continuous process/performance improvement methodology, preferred.
• Demonstrated ability to plan, coordinate, and evaluate Quality Assurance (QA) and Performance Improvement (PI) activities, preferred.
• Understanding of financial and budgeting processes and principles.
• Ability to build effective partnerships within the organization to collaboratively execute business strategies.
• Effective oral and written communication skills
• Ability to work effectively in a matrixed organization.
• Intermediate Microsoft Office proficiency (i.e., Outlook, Excel, and PowerPoint)

Education:

• Bachelor’s degree in nursing, or healthcare relevant field required.
• Master’s degree, preferred.

Work Experience/Qualifications:

• 5+ years’ experience as a clinician in an acute healthcare setting.
• 3+ years of clinical quality assurance, data analytics and reporting experience in a managed-care setting.
• Prior case management experience.
• Direct patient care experience, ICU/EM experience, preferred.
• Experience with hospital-based and outpatient clinical quality measures, strategies, and reporting.

Certifications:

• RN, required.