Healthcare Clinical Operations Director

Job Location:

Los Angeles, CA 90026

Will include expansion sites.

Reports to (title):

Chief Executive Officer

Department:

Healthcare Clinical Operations

Supervises:

Yes

Working title:

Healthcare Clinical Operations Manager

Classification:

Exempt

Salary Range:

$97,618 - $146,427 (DOE)

Status:

Regular

Hours/Week:

40

Effective Date:

March 2024

Type of Position:

Full-time

Revised Date:

March 2024

POSITION SUMMARY

Incumbent is responsible for overseeing the daily operations of the medical, behavioral health and dental facility. Provides administrative support and oversees the hiring and training of staff members, liaise with patients and healthcare professionals and coordinate patient care plans. Will work collaboratively with the

management team and other staff to actively support and carry out United American Indian Involvement's mission.

ESSENTIAL DUTIES, FUNCTIONS & RESPONSIBILITIES

• Directly manage, analyze, and monitor healthcare operations: policy review and development, patient flow, productivity, integration of services, appointment scheduling, patient time-cycle, fiscal, billing, ordering clinic supplies, etc.
• Identify and implement cost-effective approaches while maintaining high standards for clinical care (Double booking, adequate staffing, proper employee workload, and cross training)
• Supervise and participate in determination of patient eligibility for assistance programs: Presumptive Eligibility, Emergency Medical, Family Planning, Sliding Fee, etc.
• Supervise the collection of patient satisfaction surveys, and evaluate the data compared to established benchmarks
• Develop and implement processes to minimize wait time for patients and efficient communication methodologies to improve patient flow
• Insure integrated service utilization by referring patients to various other services within the clinic
• Manage and evaluate employees across three departments by training, developing, evaluating, and promoting regular and effective
• Collaborate with leadership and the Board of Directors to increase member clinic interest and participation in value-based care initiatives. These include but are not limited to Independent Practice Associations, Clinically Integrated Networks, Accountable Care Organizations, and payer- specific contracts.
• Establish strong, collaborative relationships with partner payers, especially the state Medicaid program and its Managed Care Organizations, to identify and meet mutually defined quality, health, and cost of care goals.
• Serve as the subject matter expert on value-based care and provide tailored technical assistance as/where needed.
• Determine information technology and analytic requirements, clinical and operational

staffing needs, and workflow practices to foster successful participation in value-based care.

• Work across Community Care teams involved in health analytics, value-based care or related initiatives.
• Report performance measures/metrics quarterly or as requested to the UAII Board of Directors.
• Lead clinical preparations for various audits, inspections, and certifications: Indian Health Services, Facility Site Reviews by third party payers, etc.
• Monitor regulatory compliance of patient admission, submission of medical records to billing department, authorization (health plans and IPAs), lab orders, etc.
• Implement standards for data collection and documentation to meet regulations and meaningful use criteria including: Patient demographic, up-to-date current and active diagnosis, medication reconciliation, staying healthy and smoking statues assessment, immunizations, core measures etc.
• Monitor patient care coordination and referral processes to support continuity of medical, behavioral health and dental services.
• Develop and maintain clinical policies, procedures, and protocols following all licensing, certification, and accreditation standards, including standing orders.
• Investigate and respond to complaints regarding clinical care and resolve those complaints promptly
• Provide medical leadership and supervision to clinical staff, ensuring adequate direction, training, and support is provided to perform their jobs
• Responsible for all providers hired, contracted, or volunteered, ensuring they meet the qualifications and credentials
• Lead efforts to implement a Covid19 drive-thru screening for patients, as well as conduct and monitor Covid-19 screening process and exposure protocols for all employees and patients
• Assist the AIHP in developing a plan for contract sustainability, management, and growth
• Oversee UAIICC's finances (medical supplies, equipment, staffing services, Third-Party Revenue)
• Develop goals and objectives which align with our strategic plan, including strategies and activity completing assigned objectives
• Assist in securing accreditations and awards to provide higher billing rates
• Identifies Quality Assurance issues and works with staff to make corrective actions and necessary improvements, including but not limited to directing quality improvement activities and facilitating Quality Assurance Committees for the UAIICC
• Integrate and synchronize healthcare services with all UAII programs.
• Report monthly or as requested to the UAII Board of Directors current government performance measures
• Participate in the development and maintenance of a disaster preparedness plan for the agency as appropriate
• Represent both UAII and clients in medical and regulatory communities
• Establish and maintain a professional network of current local, regional, and national health care issues and trends
• Collaborate within UAII and outside resources to promote access to care regarding patient services
• Work independently and as a team member; who consistently demonstrates professionalism, courtesy, efficiency, excellent internal and external customer service, high ethical standards, and behavior that contributes to harmonious relationships

• Maintain strict confidentiality of client and personnel information adhering to HIPAA, professional codes of conduct, conflict of interest, State of CA regulations, Privacy Act, and UAII policies and procedures
• Keep supervisor and leadership informed of activities, pending issues, and potential problems
• Adhere to policies and procedures in a manner that embodies the agency's philosophy
• Participates in special events.
• Attends staff meetings and other meetings, as required.
• Performs all other duties as assigned by the leadership team.

MINIMUM QUALIFICATIONS

Qualifications:

• Strong organizational skills that reflect the ability to perform and prioritize multiple tasks seamlessly with excellent attention to detail
• Strong interpersonal skills and the ability to build relationships with stakeholders, including staff, board members, and external partners
• Expert-level written and verbal communication skills
• Demonstrated proactive approaches to problem-solving with strong decision- making capability
• Resourceful team-player, with the ability to also be extremely effective
• independently
• Proven ability to handle confidential information with discretion, be adaptable to various competing demands, and demonstrate the highest level of customer/client service and response
• Demonstrated ability to achieve performance goals and meet deadlines in a fast-paced environment
• Actively seeks opportunities and proposes solutions
• Able to follow directions and use sound judgment when clear direction is unavailable
• Experience with health care data sources such as claims, electronic health record, clinical, and patient reported data.
• Intense attention to detail and data quality assurance.

Education & Experience:

• Graduate of an accredited school of Nursing (BSN)
• Current licensure by a CA State Board of Nursing
• Exhibit progressive professional development
• Completion of crisis management training
• Five years of working in or with a health insurer or state/federal payer, preferably in a managed care setting.
• Minimum four (4) years working directly with patients, community health preferred.
• Minimum two (2) years of administrative experience, including direct supervision of staff

Certifications:

• A plus, but not required

Confidentiality:

• Maintain strict confidentiality of client and personnel information adhering to HIPAA, professional codes of conduct, State of CA regulations, Privacy Act, and UAII policies and procedures
• This position has access to sensitive information, and a breach in confidentiality will be grounds for disciplinary action up to and including immediate termination

Communication/ Interpersonal Skills:

• Strong interpersonal, organizational, written and verbal communication skills required.
• Possess the ability to communicate with others in a courteous and professional manner
• Proficient in English
• Demonstrable ability to lead workshops in a public forum
• Ability to treat people with dignity, respect, compassion at all times
• Requires the ability to interpret and apply medical policy and provide guidance to others
• Willingness to work with culturally diverse populations of all ages

Technology Skills:

• Working knowledge of Electronic Health Records and Clinical Application
• Working knowledge of Microsoft Office, Google Suite, and general email etiquette.
• Proficient in Microsoft Office applications (Word, Excel, PowerPoint)
• Working knowledge of Google (Mail, Calendar, Drive, Meets)
• Working knowledge of Zoom or similar meeting platforms

Other:

• Available and willing to travel as needed
• Available to work evening and weekend hours as needed
• Willingness to learn new skills and participate in training sessions relevant to the position

POSITION PREFERENCES

• Experience working with the American Indian/Alaskan Native community
• Experience working with nonprofit organizations, community groups, and performance-based government contracts.
• Knowledge of Indian Self-Determination and Education Assistance Act (Public Law 93-638)
• Knowledge of Title V of the Indian Health Care Improvement Act (Public Law 94-437)
• Knowledge of the Affordable Care Act (Public Law 111-148)

WORK ENVIRONMENT

Work Environment:

The work environment characteristics described here represent those employee encounters while performing the primary functions of this job. Normal office

conditions exist, and the noise level in the work environment can vary from low to moderate.

Physical Demands:

The physical demands described here represent those that an employee must meet to perform the primary functions of this job successfully. While performing the duties of this job, the employee is required to stand, walk frequently, sit, bend, twist, talk, and hear. There are prolonged periods of sitting, keyboarding, reading, and driving or riding in transport vehicles. The employee must occasionally lift and move up to 25 pounds. Specific vision abilities required by this job include reading, distance, computer, and color vision. Talking and hearing are essential to communicate with staff and vendors.

UAII will make any practical, feasible, and reasonable arrangements to

accommodate qualified applicants and employees with disabilities if it can do so without undue hardship.

PERFORMANCE EXPECTATIONS

In the performance of their respective tasks and duties, all employees of United American Involvement, Inc. (UAII) are expected to conform to the following:

• Uphold all principles of confidentiality and patient care to the fullest extent
• Meet or exceed the performance standards as set by your supervisor
• Interact in an honest, trustworthy, and dependable manner with clients, employees, and vendors
• Possess cultural awareness and sensitivity
• Adhere to all professional and ethical behavior standards as outlined in UAII's Employee Handbook
• Work independently and as a team member; consistently demonstrate professionalism, courtesy, efficiency, excellent internal and external customer service, high ethical standards, and behavior that contributes to harmonious relationships

EQUAL EMPLOYMENT OPPORTUNITY

United American Indian Involvement, Inc. (UAII) provides equal employment opportunities to all employees and applicants for employment. It prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

UAII abides by the mandates of the ADEA and the Fair Employment Housing and Housing Act (FEHA)- protecting individuals 40 years and older-and considers age a non-merit factor in all employment decisions and considerations.

UAII abides by the mandates of the ADA and FEHA and considers disability a non-merit factor in all employment decisions and considerations. Furthermore, UAII will make any practical, feasible, and reasonable arrangements to accommodate qualified applicants and employees with disabilities if it can do so without undue hardship. Applicants and employees may request accommodations for a disability at any time in the application process or during employment.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

OTHER EMPLOYMENT REQUIREMENTS

• Eligibility to work in the US
• Fingerprint clearance
• Pass a post-offer drug test
• Negative TB test result (annual requirement)
• Prove of vaccination against the flu (annual requirement)
• Prove of full vaccination against COVID, including the latest Booster
• Valid CA driver's license if driving for the organization
• Maintain auto insurance coverage if driving for the organization

BENEFITS

UAII offers a comprehensive and robust benefits package that includes:

• Medical, Dental, Vision
• Voluntary Accident, Critical Illness, Hospital Indemnity Insurance
• Company-paid Short-Term & Long-Term Disability
• Company-paid Basic Life Insurance and AD&D
• FSA Medical and Dependent Care
• 403(b) Retirement Plan with Employer Match
• LegalShield
• TotalCare Employee Assistance Program
• 12 Vacation Days (first year)
• 13 Paid Holidays
• 3 Personal Days

• 7 Sick Days
• Bereavement and Jury Duty paid leave
• Employee Wellness Program