I. INTRODUCTION
A. This is a regional position located in the Clinic Administration department of the Hawai’i Health Systems Corporation (HHSC) Kaua’i Region, which includes Kaua’i Veterans Memorial Hospital (KVMH), Samuel Mahelona Memorial Hospital (SMMH), and The Kaua’i Region Clinics, operating under the public benefit corporation of the State of Hawai’i.
B. The Clinic Administrative Director (Regional) is responsible for the administrative functions of the region’s employed and contracted provider practices including operations, procurement, corporate compliance, marketing, finance, provider compensation and reimbursement, human resources, medical and business information systems and planning and development. The Clinic Administrative Director shall also oversee personnel with direct responsibilities for the specific functional areas of employed and contracted provider services and other functions as assigned by the Regional Chief Executive Officer. Position is subject to travel to and from facilities within the region.
C. This position reports to the Regional Chief Medical Officer (RCMO), position no. 109715 or its designee.
- MAJOR DUTIES & RESPONSIBILITIES
A. Operations Management 75%
1. With the Regional Chief Executive Officer (RCEO) and RCMO, plans, organizes, directs and controls Clinic provider practices for the region.
2. Provides leadership in the conception, planning, development and implementation of clinic business plans to the Kaua’i Region Provider’s Group.
3. Recommends, develops and implements and updates strategic initiatives to ensure maximum achievement of financial targets and operations excellence and support the clinic’s philosophy and goals.
4. Performs process redesign to support providers with efficient operations and throughput.
5. Responsible for the monthly production reports for individual providers and office locations.
6. Oversees general and administrative activities of contracted provider services. Responsible to the RCMO to develop and ensure that all provider contracts for the region are done in accordance with established policies and procedures, Corporate Compliance requirements and all Stark laws.
7. Recommends, develops and implements the planning and development of provider contract specifications and scope of work, including but not limited to developing milestones, implementation schedule or response times as applicable, developing performance measures to determine the effectiveness of the work performed and provides support for Executive Leadership relating to the technical aspects of the provider contracts.
8. Ensures that no provider shall be allowed to provide services prior to the execution of the contract, after a contract has expired and once the not-to- exceed (NTE) amount has been exhausted.
9. Responsible for initiating the necessary forms and process to amend, extend or supplement provider contracts in sufficient time to place the desired contract in compliance with applicable laws and regulations.
10. Collaborates with the RCEO, RCMO, and Executive Leadership staff to ensure collaboration between providers and regional leadership to ensure excellence in Clinic quality outcomes and customer service.
11. Initiates the development and implementation of policies and procedures that govern the contracted provider services in collaboration with the internal/external customers that they serve in coordination with Medical Directors and Executive Leadership within the region
12. Develops short-term and long-term goals and objectives for the contracted provider services that further those goals and objectives of the Region and HHSC.
13. Participates in contracted provider services planning, decision-making, and policy formulation to improve the delivery of patient care.
14. Establishes and maintains applicable benchmarks for each specialty and regularly monitors performance with the continual goal of improving efficiency. Recognizes areas of operational deficiencies and provides leadership toward improvement.
15. Advises the RCEO and RCMO about problems relating to contracted provider services and implements changes in administrative policies to carry out objectives of the region more effectively.
16. Assists with provider practice issues for the Critical Access Hospitals within the Kaua’i Region.
17. Ensures that contracted providers are covered by all state compliance issues, insurance, credentialing and fair market value documents are updated and submitted to HHSC as needed. Establish reporting and communication procedures for credentialing of contracted providers.
18. Assists in all provider practice services compliance issues. Participate in the regional compliance committee on compliance initiatives and correction action plans to prevent reoccurrence.
B. Staffing, Budgeting and Financial Planning 15%
1. Establishes provider practice requirements and works with the RCMO for recruitment, selection, and placement of qualified medical staff.
2. Collects and analyzes data to determine staffing patterns in an effort to provide the most efficient service possible. Analyzes and evaluates the delivery of services to improve outcomes. Provides reports to the RCEO, RCMO and Executive Leadership as directed.
3. Promotes and maintains professional, collaborative, effective relationships amongst all hospital stakeholders (patients, community, employees, medical staff and senior management) to foster a system friendly environment and supporting a team approach to management.
4. Assists the RCMO in the oversight of planning, developing, implementing, monitoring and controlling the annual operational budget and allocation of funds in the capital budget for contracted provider services to ensure cost-effective delivery of services. Makes adjustments throughout the year as necessary to achieve these goals.
5. Assists the RCEO, RCMO, and Executive Leadership in formulating plans, goals and objectives for new provider practices.
6. Coordinates with the Regional Executive Leadership and appropriate managers to establish appropriate provider practices in conjunction with new programs and services in response to stakeholder and community needs.
7. Responsible for reviewing and approving accurate and timely process of all invoices and charges for billing purposes, and monitor statistics, charges and receipts by provider and provider specialty. Ensures all payments are done in accordance with contracted financial arrangements Corporate Compliance practices, policies and procedures and regulatory requirements. Verifies that sufficient funds exist in the not-to-exceed (NTE) amounts of each contract.
C. Other Duties and Responsibilities 10%
1. Conducts special projects, assignments, and research programs as directed by the RCEO.
2. Fosters positive communication, exemplifies excellent customer service, encourages teamwork, collaborates professionally, and supports all levels of interaction with patients, visitors, providers, staff, and the community.
3. Maintains compliance with all mandatory in-service and infection control/employee health requirements.
4. Maintains the strictest confidentiality of all facility and facility related employee and patient information.
5. Participates in activities of department, i.e., Joint Commission, Safety, Performance Improvement and Infection Control.
6. Adheres to all HHSC Kaua’i Region policies and procedures.
7. Provides assistance in emergencies, participates in disaster drills, and engages in committee and training meetings and educational sessions.
8. Adheres to hospital rules and regulations and policies and procedures.
9. Plans and organizes workload and is aware and flexible to acute needs of the section.
10. Performs other duties as assigned. _____
100%
III. EDUCATION, EXPERIENCE, CERTIFICATION, LICENSURE
A. Education: Masters Degree in Public Health and/or Hospital Administration or its equivalent preferred.
B. Experience: A minimum of five (5) years of progressively responsible administrative work is required. Experience in provider practice contractual management or its equivalent preferred.
C. Certification: Must obtain Certified Director in Provider Practice Management certification within three (3) years of employment. (A PLUS IF THEY HAVE ALREADY)
D. Licensure: Current, valid State of Hawai’i type# 3 driver’s license preferred.
IV. DESIRED SKILLS
Successful candidate must have strong interpersonal communication skills, with extensive experience in provider practices. Health administration experience is preferred. Current knowledge of issues and trends facing the healthcare industry, especially in a rural setting, is also required.
Knowledge of: administrative functions, principles, procedures and practices of provider contract services, organization and administration; operations and functions of multi-specialty provider practices; standards of group practice management associations; Federal, State and County Governments as related to provider contract services including Stark and procurement regulations, supervisory and safety practices, and public relations.
Maintain good relationship with providers, patients, visitors, employees and others; appear before various groups and individuals and articulate problems as they relate to the provider contract services, execute and implement plans and orders from the RCEO; comprehend and interpret laws, statements and other communications; analyze and solve problems; prepare reports; coordinate provider contract functions and direct the work of others.
V. NATURE OF SUPERVISION
A. Supervisor: RCMO, position no. 109715, or its designee.
B. Supervises: Indirectly supervises provider contracted services staff and other staff members as assigned.
C. Instructions/Assistance/Review of Work: This position exercises wide latitude of independent initiative and judgment in carrying out responsibilities. Work is generally unsupervised. Has substantial input to formulation of outpatient clinic policy. Deals with complex organizational issues and problems. Coordination with all departments is a definite requirement. Refers only difficult and/or unusual cases to the RCEO or RCMO as needed. Work is evaluated and spot-checked periodically for accuracy.
VI. WORKING CONDITIONS / HEALTH & PHYSICAL REQUIREMENTS
Applicants must meet the health and physical requirements deemed necessary to effectively and safely perform the essential functions of the position with or without reasonable accommodation.
Subject to long and irregular hours and many interruptions. Work requires great deal of time and tolerance for stress.