Manager, Clinical Quality Operations

Overview:  The Manager, Clinical Operations will be responsible for field oversight of our in-home assessment Nurse Practitioner and Physician Assistants. The focus of this role is on the day to day delivery of excellence in the quality of care, ensuring all clinical and operational policies and procedures are followed and production targets are met. 

Duties and Responsibilities: 

• Manage large network of field-based mid-level practitioners; 
• Partner with department leaders in strategic planning and review of dashboards and reporting to drive operational excellence; 

• Conduct 1:1 check ins with your providers at least twice a month to include a review of their current performance and any necessary coaching; 
• Review the results of audits of medical records performed by the Clinical Auditor; 
• Review clinical monitoring reports for trends or individual issues; 
• Develop/Review the clinical resource scorecard that summarizes the results of audits, clinical monitoring and operational monitoring reports for trends and individual issues; 
• Provide specific one-on-one coaching on quality issues identified in review of the clinical resource’s audit results; 

• Identify clinical resources requiring referral to a remediation training course; 
• Identify clinical resources whose performance warrants referrals for a Quality Improvement Program; 
• Assume role of clinical resource when questions arise in the field; 
• Prepares documentation tracking coaching efforts and results of coaching efforts; 
• In conjunction with the clinical training team, identify training needs, contributes to training material development, and support its implementation; 

• Participate in key organizational meetings providing details specific to audit activity and outcomes; 
• Maintain compliance with ComplexCare Solution's policies, procedures and mission statement; 
• Adhere to all confidentiality and HIPAA requirements as outlined within ComplexCare Solution's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position; and 
• Fulfill those responsibilities and/or duties that may be reasonably provided by ComplexCare Solutions for the purpose of achieving operational and financial success of the Employer. 

Job Requirements: 

• Minimum of 5 years of management experience desired with an interest in Healthcare Field and Career; 
• Goal oriented, results focused and self-motivated; 
• A self-starter; ability to work in a Team Environment; 
• Ability to create a positive and motivating work environment; 

• Excellent written and oral communication skills; 
• Ability to organize his/her time and work without direct and daily supervision; 
• Strong interpersonal and organizational skills; 
• Ability to work in a fast-paced environment and prioritize tasks to meet deadlines and goals.   
• Knowledge of Microsoft Office Products, particularly Outlook and Excel; and 

• Ability to exercise independent judgment within policy and procedure guidelines established by the company. 

Education: 

• Bachelor’s Degree; 
• Must be have current license and credentials as RN or LPN; and 
• Coding knowledge (CPC preferred, but not required). 

Physical Demands and Work Environment: 

• Sedentary work (i.e. sitting for long periods of time); 
• Exerting up to 10 pounds of force occasionally and/or negligible amount of force;  
• Frequently or constantly to lift, carry push, pull or otherwise move objects and repetitive motions; 

• Subject to inside environmental conditions; and 
• Travel for this position will include less than 5% locally usually for training purposes.