Job Description

Our direct client is seeking a Director of Patient Care to join their team for a full-time, permanent opportunity.

J ob Summary: Oversees all clinical operations, performance improvement activities, training and supervision of nursing and field staff and medical compliance issues.

Reports To: AVP, Home & Community Based Services and/or Chief Financial Officer

Duties and Responsibilities:

1. Develops and administrates a clinical program for the delivery of care to clients.

• Participates in the development, updating and revision of agency policies and procedures.
• Interprets agency policies to staff, clients, families and other individuals or organizations as required.
• Ensures that clients are fully assessed upon admission to the agency.
• Ensures that clients are accepted for admissions according to the agency's criteria and policies.
• Ensures that a plan of care is developed and recommended for all clients receiving care.
• Provides for continuity in the care of clients by ensuring that the established plan of care is implemented.
• Ensures that all services provided to clients are coordinated to guarantee the provision of safe and adequate care.
• Ensures compliance by staff with all applicable Federal, State and local regulatory and accreditation standards.
• Ensures that required professional and ancillary services are provided when necessary.
• Covers for Staff Nurses when necessary.
• Ensures that clients' records are based on local, state and federal regulations as well as accreditation standards.
• Provides supervision to nursing and paraprofessional staff as required.
• Leads the quality assessment, quality program management and quality

2. Performance improvement strategies in collaboration with senior leadership and service delivery management.

• Works to advance, develop, implement and refine quality and safety programs at the inter-professional level through consultation, program activities and collaboration across company Health Plans.
• Participates in the development of quality metrics to support performance improvement initiatives and quality/compliance oversight.
• Serves as quality subject matter expert with other stakeholders to drive quality management strategy.
• Builds shared vision to incorporate a culture that is data driven and aligns with evidenced based best practices that are compliant with CMS and NYS DOH requirements.
• Facilitates and supports operational changes and activities which support quality improvement and clinical staff development goals.
• Works under general direction.
• Monitors and ensures the implementation of the performance improvement plan and program.
• Facilitates all performance improvement activities.
• Ensures compliance with complaint procedure.
• Receives, reviews and ensures compliance with incident/accident reporting procedures.
• Ensures compliance with infection control policies and procedures.
• Monitors quality of care delivered by staff through record review, conferences, supervisory visits and review of aggregated data.
• Participates in agency's P.I. plan by conducting and organizing data collection and tabulating results.
• Participates in defining, monitoring and interpreting standards of practice by all clinical staff.
• In collaboration with Senior Management, prepares schedules, agendas and minutes for the Performance Improvement committee.
• Facilitates performance improvement process teams.
• Provides progress report to Senior Management
• Reviews and analyzes data and ensures dissemination of appropriate information to staff.
• In collaboration with Senior Management analyzes and reviews the Performance Improvement Plan as needed.
• Identifies and recommends opportunities for improvement.
• Develops and implements performance improvement education programs and activities and participates in the orientation of all staff in performance improvement concepts.

3. Develops and administrates a program for the orientation, training and competency measurement for all field staff.

• Ensures the orientation of field staff to the agency's policies and procedures and their job responsibilities.
• Ensures that competencies of field staff are measured at the time of orientation, annually and as needed.
• Ensures that clinical staff receives required in-service programs.
• Develops in-service programs that meet government and accreditation standards and are clinically and educationally appropriate for the staff.
• Ensures that field staff is supervised via in-house visits and/or laboratory setting observations.
• Aggregates and analyzes data from tests and/or competency testing.
• Implements action plans to address findings.

4. Monitors the health status of staff.

5. Provides conflict resolution.

6. Demonstrates a commitment to customer service and quality care provisions.

7. Ensures that activities are cost effective.

8. Attends appropriate meetings, care conferences, in-services, etc.

9. Leads the development of the quality improvement program for assigned product lines.

10. Designs, initiates and leads strategies and projects that foster the application of continuous improvement principles and best practices among Medicare and Medicaid products, in collaboration with senior leadership and service delivery management.

11. Designs and evaluates clinical support and education programs that are integrated with and facilitate quality improvement strategies and achievement of the Enterprise’s strategic objectives.

12. Develops strategic plans and policies for improved quality for all lines of business and works with senior leadership to ensure compliance with regulations.

13. Develops strategies and methods for the collection, analysis and dissemination of clinical performance data.

14. Serves as a subject matter expert to leadership, internal service delivery management and network providers in the areas of quality assessment and performance improvement initiatives.

15. Evaluates the impact of industry and regulatory changes on the Quality Improvement programs; recommends appropriate and necessary changes. Leads implementation of such changes.

16. Participates with other staff in interacting with regulatory, health and community agencies in identifying and influencing public policy issues that relate to the health plans. Represents the company internally and externally and increases public awareness of program through education, presentations and marketing of services.

17. Ensures quality initiatives are aligned with CMS triple aim framework: improving members’ experience of care (including quality and satisfaction), improving the health of populations and

reducing the per capita cost of healthcare.

18. Directs company quality metrics related to regulatory compliance and performance improvement initiatives.

19. Functions as the Quality liaison for the development of analytic systems and databases that support the development of systems and strategic initiatives as requested by the Enterprise.

20. Develops strategies and methods for collection, analysis and evaluation of the quality improvement projects. Oversees project work plans, including objectives, tasks and time frames to ensure deliverables are completed on time. Identifies and responds to changing project circumstances and communicates issues to leadership as appropriate. Initiates and leads project evaluation process at project close.

21. Keeps informed of the latest internal and external issues and trends in utilization and quality management through select committee participation, networking, professional memberships in related organizations, attendance at conferences/seminars and select journal readership. Revises/develops processes, policies and procedures to address these trends.

22. Collaborates with operations management in the development of action plans based on quality reviews and root cause analysis findings. Makes recommendations to appropriate staff and/or committees about findings of reviews, surveys and studies. Ensures corrective actions for regulatory issues, compliance or deficiencies identified in patient complaints/incidents are implemented effectively.

23. Performs all duties inherent in a senior managerial role. Ensures effective staff training and evaluates staff performance. Approves staff training, hiring, promotions and terminations and salary actions. Prepares and ensures adherence to the department budget.

24. Participates in special projects and perform other duties as required.

Job Qualifications:

• Current license and registration to practice as a Registered Nurse in New York State.
• Bachelor's Degree in Nursing.
• Minimum of 3 years of clinical supervisory experience and 1 year of home care experience required.
• Current New York State Driver's license and access to a car.

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