Title: Director of Patient Services
Job Classification: Exempt
Reports To: Chief Operating Officer
Supervises: Supervising Nurse, Field RNs/LPNs/PT/OT/Speech Therapist
JOB SUMMARY:
The Director of Patient Services assists the Chief Operating Officer in planning, organizing, directing and enforcing all personnel and service policies and procedures that the Clinical and PCA/HHA Field Operations Unit must adhere to. Provide leadership, direction and supervision to the PCA and Clinical Operations Unit on all patient care delivery processes and procedures. Develop, and in some cases, modify and implement ACHC’s personnel and patient service policies and procedures as per payor contractor deliverables and NYS DOH regulatory mandates. Interface with payor/ contractors on matters pertaining to patient and service referrals, patient service issues, patient complaints, patient enrollment and patient service termination, program audits, fraud investigation and quality improvement initiatives. Review and supervise referrals for skilled nursing assessments, medication management and all other skilled nursing services contracted with ACHC. Ensure quality control in nursing reports and other regulatory/statistical reports sent out to Payors/contractors and NYS DOH. Ensure compliance with NYS DOH, ACHC accreditation, MLTC and ALL Payor regulatory mandates and audit requirements, which include but not limited to customer satisfaction surveys, attendance verification, CHRC background checks, Field workers’ hiring requirements, in-service training, annual medical examinations, discharge coordination, routine nursing visits, HIPAA law and maintenance of patient/worker file records. Supervise Supervising RNs, Administrative RNs, LPNs, Rehabilitation per diem Clinicians, (PT,OT,Speech Therapy) RN In-service Training Instructor.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Review all patient intake referrals with the Intake Director to ensure that all initial cases are visited and admitted within mandated ACHC accreditation and Payor/Contractor time limits.
- Review all re-authorized, downgraded or upgraded (service hours) cases to ensure arrangements for coverage are in accordance with Payor/Contractors’ service authorization.
- Monitor full compliance on the RNs conduct of skilled nursing assessment, provision of skilled nursing services, i.e. medication management, wound care, etc. DSS field visits, MLTC, NYS DOH and other Payor required report submissions.
- Institute disciplinary action if routine and authorized skilled field visits are not done in compliance with NYS DOH and Payor/Contractor time limits.
- Respond to and manage the review, investigation and completion of all patients, field workers’ complaints/incidents within stipulated NYS DOH and Payor/Contractor time limits and standard procedures.
- Communicate and liaise with referral sources from various payor/contractor entities on matters pertaining to case admissions, case deferral, case conferences, crisis intervention issues and all other matters requiring case consultations.
- Review all patient intake referral packets with the Intake Director/ Coordinator to ensure that all initial cases are visited and admitted within mandated Payor/Contractor time limits.
- Review all re-authorized, downgraded or upgraded (service hours) cases to ensure arrangements for coverage are in accordance to Payor’s service determination.
- Review patient discharges to ensure the correct completion and submission to PCPs and Payor/Contractor discharge reports on service termination, following hospitalization over 31 days, death, relocation, and refusal of service.
- Review and monitor case attrition and reasons behind case terminations.
- Acts as Chairperson of the Compliance and Quality Assurance Committees. Monitor periodic conduct of quality assurance unannounced visits and telephone calls.
- Review and recommend corrective measures on issues raised during compliance and quality assurance meetings.
- Develop, and in some cases, modify and implement the ACHC’s personnel and patient care policies and procedures as per Payor, NYS OMIG and NYS DOH regulatory mandates.
- Ensure the ACHC’s full compliance with Home Attendants, Homecare workers’ physicals; Ensure that medical reports and clearances are acceptable and meet NYS DOH guidelines for new hires and continued employment.
- In collaboration with the HR Coordinator, develop, update and implement the ACHC’s pre-employment and in-service training sessions as per Payors and NYS DOH mandates.
- Institute the necessary progressive discipline measures to resolve job performance issues and patient complaints in the delivery of homecare and skilled nursing services.
- Ensure ACHC’s compliance with documenting annual physicals, in-service attendance of Field employees, patient contacts, homecare workers and Clinician job evaluations and quality assurance checks.
- Ensure the staff’s full compliance with documenting patient and homecare workers complaint log, casenote preparation when patient incidents and other significant events take place, complaint investigation and other necessary case specific reports.
- Provide leadership, direction, and supervision of the Nursing Unit.
- Develop, and in some cases, modify and implement the Agency’s patient care policies and procedures as per audit outcomes, Payor and NYS DOH regulatory mandates.
- Conduct routine weekly management meetings with Field Nursing staff to discuss and address service issues and concerns with the aim of enhancing methods of service delivery and internal operations.
- Authorize and approve all field visits of Nursing staff.
- Conduct probationary and annual performance reviews for all administrative and per diem staff in the Nursing Unit.
- Interview and select new field nurses, in consultation with the Executive Director.
- Institute progressive disciplinary measures to correct job performance deficiencies and complaint resolutions.
- Liaise with the community to increase program awareness and advocacy and secure resources for the program. Collaborate with Nurses on Clinical Records Review, Risk Management, and Infection Control and case assignments.
- Responsible for activating and routinely conducting all requirements related to the ACHC’s emergency preparedness policies and procedures.
- Review and approve all initial patient files/paperwork.
- Review and follow up on all complaints, patient/Homecare worker incidents and incident reports
- Assure that the Intake Coordinator communicates and arrange case coverage for a patient discharge from hospital.
- Consults with physicians on matters relating to patient care service.
- Provide quarterly QA reports to the Executive Director prior to presentation to QI Meetings.
- Implement and approve methods and procedures that reflect the high quality of care.
- Establishes methods and new curriculum to facilitate and attain the objectives of the in-service training program.
- Perform other duties assigned by the Executive Director
Qualifications/Education:
- Baccalaureate degree with 3 yrs. of full time experience in public administration, health care or community services; at least 2 yrs. must be in a supervisory capacity.
- A NYS Licensed Registered nurse must possess 5 yrs. of full time work experience and at least 2 years in a supervisory capacity. Up to one year of related graduate education may be substituted for one year of related experience in public administration but not for supervisory experience.
- Excellent oral and written communication skills.
- Demonstrated proficiency in program management and supervision.
Requirements:
1. Pre-employment and annual medical examinations.
2. Unwavering commitment to the agency’s mission.
3. Action-oriented, entrepreneurial, flexible, and innovative approach to operational management
4. Ability to commit and adhere to the Agency’s mission through the demonstration of the highest level of moral character traits, including honesty, humility, integrity, and optimism; Ability to handle multiple tasks.
5. Ability to handle multiple tasks.
6. Ability to resolve problematic situations.
7. Computer Literate on Microsoft word.
8. May be required to conduct field visits, when necessary.
9. Possess excellent interpersonal skills and ability to work well with others.
Always Compassionate Health is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment. All employment decisions at Always Compassionate Health are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, creed, national, social or ethnic origin, political viewpoint, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, protected veteran status, citizenship status when otherwise legally able to work, or any other status protected by the laws or regulations in the locations where we operate.
Pay: $150,000.00 - $200,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
