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Position Summary:
Directs and manages the healthcare organization's reimbursement activities and initiatives to ensure timely and accurate government and financial reporting. Develops and implements strategies, policies, procedures, and programs for all aspects of reimbursement management practices. Promotes a thorough department and system understanding of reimbursement and government payer regulations, support for Dignity Health advocacy efforts, and formulation of reimbursement strategy. Monitors federal and state regulatory proposals and changes regarding healthcare reimbursement and provides effective solutions to address reimbursement issues. Oversees, evaluates and improves the productivity and performance of staff members.
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This position is responsible for managing the Value Based Agreements and Risk contracting activities for Dignity Health’s hospitals in Southern California and surrounding areas. This position will be based in Southern California area and will require travel to other Dignity Health offices and/or Physician Group offices and all affiliated Management Services Organizations (MSO).
The position is responsible for: planning and organization of Joint Operations meetings with each affiliated capitated IPA/MG who must collaborate with the respective MSO staff who is directly responsible for ensuring clear communication, timely/accurate dashboard reports, financial reports, risk pool settlements, etc. Director of Risk Contracting establishes priorities of effective risk pool management and the areas of focus in support of pool profitability, process development and implementation for the Southern California service area Value Based Agreements; contributing to strategic planning; strategy implementation; maintaining and developing relationships with Dignity Health’s internal departments & stakeholders, with Dignity Health’s affiliated Physician Groups/Foundation, negotiating and maintenance of entire Ancillary/Vendor network and provider agreements associated with Dignity Health’s Institutional capitated risk contracts and creating Centers of Excellence where applicable; Externally with affiliated Physician Groups and Management Services Organizations (MSOs); planning, organizing, directing and conducting IPA negotiations, risk pool settlements, Risk Share Agreement renewals in collaboration with the respective hospital Director of Managed Care, and implementation of managed care agreements with current and prospective purchasers or providers of healthcare services on behalf of DIGNITY HEALTH. The contracts include such payer entities as HMO’s (various products: MA, Medi-Cal, Duals, Commercial), and various risk bearing organizations such as Banker Hospitals, IPAs/Medical Groups and Restricted Knox-Keene organizations.
By securing optimal reimbursement and protecting the interests of the hospitals in contract negotiations and the implementation and management of managed care contracts and relationships, this position is essential to DIGNITY HEALTH and individual hospital’s financial performance related to Value Based Agreements and the overall management of In Network and Out of Network spend.
This position is also responsible for collaboration, communication, and facilitation between Managed Care and other key stakeholder departments within DIGNITY HEALTH including special projects that involve collaboration with IPAs to optimize reimbursement for OB Kick payments, HCC reimbursement maximization, Out of Network utilization reductions projects, Quality Incentive program coordination, Population Health initiatives, Community Resource coordination, Capitation revenue and reconciliation oversight of MSOs reports and responsibilities, and all other payment innovation associated with Risk Contracting arrangements.
PRINCIPLE ACCOUNTABILITIES
- Negotiate contracts with existing payors (health plans and physician organizations) based on prior contract performance, future potential and current strategic and financial goals.
- Develop and enhance relationships with internal and external contacts. Proactively plan, prioritize, and communicate regarding projects, issues, and negotiations to ensure relationships are maintained and DIGNITY HEALTH’s values are demonstrated on a day-day basis and when difficult business decisions need to be made.
- Lead and coordinate activities of personnel in the analysis, negotiation, and management of existing managed care contracts. This includes the maintenance of a variety of activity reports in support of financial reporting as related to managed care contract performance.
- Analyze contractual language for functional, financial, and ethical appropriateness. Determine compliance with established legal requirements and negotiate contract language for signature in a manner consistent with the authority as delegated to this position by DIGNITY HEALTH legal counsel.
- Coordinate implementation of HMO, PPO, and other managed care contracts with Patient Financial Services, Admitting, Case Management, etc. Develop and maintain systems and procedures to disseminate pertinent contract information in a timely manner to appropriate regional and hospital personnel.
- Represent DIGNITY HEALTH in meetings with other organizations, associations, providers and payors regarding all aspects of managed care.
- Ensure the maintenance of comprehensive current correspondence and contract files relating to managed care agreements.
- In coordination with the Directors of Patient Financial Services and Central
Business Offices (CBO’s), develop, implement and maintain unambiguous rate structures that ensure efficient, automated billing and collections to ensure receipt of proper payment from contract payors. Assist PFS as necessary with updates to insurance code information.
- As appropriate, coordinate with IT and other system and hospital departments regarding the operation, utilization and selection of managed care related information systems such as HBO-CPA, Ascent, and other systems. Ensure the maintenance of the managed care contract rate information, modeling, updated reports and analysis for expected reimbursement systems.
- Work in tandem with other Managed Care Directors and personnel regarding managed care activities.
- Serve in a lead role within DIGNITY HEALTH regarding managed care activities, including serving on various DIGNITY HEALTH committees, task forces and negotiating teams.
- Ensure that all contracts and departmental actions follow the HIPPA regulations/guidelines.
- As requested, provide consultative support to the hospital senior and middle management teams with respect to managed care and related issues. Perform work on unique projects as requested by the Vice President, Managed Care and/or Senior Vice President, Managed Care.
- Prepare agendas, attachments, analysis, recommendations and minutes for Managed Care meetings as needed.
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Position Summary:
Directs and oversees the quality, budgeting, staffing, regulatory compliance and daily operations in multiple and diverse clinic areas within the provider practices of the Cancer Center. Focuses on system integration and workflow efficiencies to enhance and optimize the patient and provider experience. Responsible for the business development and growth of the oncology program.
Principle Duties and Accountabilities:
- Directs and oversees the quality, budgeting, staffing, regulatory compliance and daily operations in multiple and diverse clinic areas within the provider practices of the Cancer Center. Focuses on system integration and workflow efficiencies to enhance and optimize the patient and provider experience. Responsible for the business development and growth of the oncology program.
- Directs daily operations for all areas of responsibility including patient management, physician relationships, supply management, and regulatory compliance. Accountable for adherence to standards of care, scope of practice for all licensed/certified staff, quality initiatives, regulatory related quality issues, and patient outcomes.
- Directs daily operations for all areas of responsibility including patient management, physician relationships, supply management, and regulatory compliance. Accountable for adherence to standards of care, scope of practice for all licensed/certified staff, quality initiatives, regulatory related quality issues, and patient outcomes.
- Strategically plans and forecasts multi-year budget. Directs cost management efforts including reviewing and approving budgets developed by managers. Assists the managers to administer the annual budget to meet or improve practice performance in supply management and staffing expenses.
- Works with the strategy team on business plans to help grow the Cancer Center. Implements new programs and coordinates needed resources including staff, equipment, space, and physicians. Plans new capital acquisitions in partnership with physicians and strategy. Collaborates with community partners to grow and build programs and services. Develops long term marketing plans.
- Oversees all aspects of staff management including coaching and educational development. Provides leadership and serves as a mentor to the Oncology team.
#LI-DH
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Position Summary:
The Labor Management team in our Performance Improvement Department is responsible in developing and implementing staffing standard standard practices, labor productivity guidelines, labor budget target settings and other labor staffing tools and processes.
This position is responsible for providing consulting services which will contribute to the fiscal and operational well-being of Dignity Health (Dignity Health), in a manner consistent with the Mission and Philosophy of Dignity Health. The position is responsible for identifying needed improvements on a significant level in operating efficiencies and labor cost reductions. The position directs management engineering and other consulting services for 40+ hospitals and affiliates of Dignity Health. The project work, consultation, management training and management reporting are aimed at improving the efficiency, cost effectiveness and quality of operations for all Dignity Health related entities. The principal focus is on labor cost management, which currently represents an annual expense in excess of $1,500,000,000 for 35,000 FTE's. Continual significant cost reductions through process redesign and strong management of labor costs are required for the ongoing success of Dignity Health.
Strong preference for Labor Management experience.
~LI-DH
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Position Summary: Directs the provision of nursing care in a business unit while maintaining standards of patient care. Principal Duties and Accountabilities:
- Responsible for the overall quality of care provided by the nursing personnel. Advises medical staff, department heads, and administrators in matters related to nursing service and strategies.
- Interprets policies and objectives of nursing service to staff and community groups.
- Monitors the operations of the nursing staff and ensures compliance with regulations on organizational and governmental standards and practices. Schedules staff and conducts employee performance reviews.
- Provides nursing care to patients on an as needed basis.
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Position Summary: Directs the provision of nursing care in a business unit while maintaining standards of patient care. Principal Duties and Accountabilities:
- Responsible for the overall quality of care provided by the nursing personnel. Advises medical staff, department heads, and administrators in matters related to nursing service and strategies.
- Interprets policies and objectives of nursing service to staff and community groups.
- Monitors the operations of the nursing staff and ensures compliance with regulations on organizational and governmental standards and practices. Schedules staff and conducts employee performance reviews.
- Provides nursing care to patients on an as needed basis.
~LI-DH
~LI-DH
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Position Summary: Participates in the planning and implementing of major facilities' construction/renovation projects to ensure the safe and effective placement of imaging equipment and efficient operations. Monitors staff performance and participates in the development of competencies, performance standards and imaging protocols for the department. ~LI-DH Principal Duties and Accountabilities:
- Directs the application of diagnostic imaging technology and regulatory standards.
- Maintains policies, protocols and procedures to meet regulatory standards, ensuring equipment and procedures are safe, functional and capable of meeting the diagnostic needs.
- Participates in the planning and implementing of major facilities' construction/renovation projects to ensure the safe and effective placement of imaging equipment and efficient operations.
- Monitors staff performance and participates in the development of competencies, performance standards and imaging protocols for the department.
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Position Summary: Provides direction and leadership to the Respiratory Department. Ensures that the department meets the requirements of all regulatory agencies. Prepares and justifies annual budgeting including anticipating realistic volume trends. Implements control in fiscal management of the department. Plans and implements new services plan and implements department changes. ~LI-DH Principal Duties and Accountabilities:
- Prepares and justifies annual budgeting including: anticipates realistic volume trends. implements control in fiscal management of the department. Manages department budget within fiscal year approved targets.
- Works in collaboration with the Department Managers and Directors to develop and implement integrated policies and procedures. Ensures that standards and policies and procedures are followed in daily practice.
- Compiles continuous quality improvement projects in coordination with key personnel: plans and implements new services plan and implement department changes.
- Insures compliance with accreditation, certification, licensure and government standards relevant to the different cardiopulmonary/neurodiagnostic services. Ensures CLIA and CAP regulations are met in the Blood Gas Laboratory.
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Position Summary: Directs the provision of nursing care in a business unit while maintaining standards of patient care. Principal Duties and Accountabilities:
- Responsible for the overall quality of care provided by the nursing personnel. Advises medical staff, department heads, and administrators in matters related to nursing service and strategies.
- Interprets policies and objectives of nursing service to staff and community groups.
- Monitors the operations of the nursing staff and ensures compliance with regulations on organizational and governmental standards and practices. Schedules staff and conducts employee performance reviews.
- Provides nursing care to patients on an as needed basis.
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Position Summary: Under the direction of the senior director, leads the facilities Care Coordination and Social Services, including but not limited to clinical resource management, discharge planning activities, patient advocacy, clinical social work and best practice in medical necessity determination and concurrent review. Principal Duties and Accountabilities:
- Directs and manages areas including planning, organizing and directs all activities, staffing, performance improvement in the delivery of clinical services (such as LOS reduction). Reports needs within the Medical Center and Dignity Health, as well as government and regulatory reporting.
- Guides Care Coordination activities according to the needs, requirements, and policies of the Medical Center, the affiliated medical groups and health plans, Dignity Health, any Federal and State agencies, and according to standard practices of the professions under the director's accountability.
- Consults and collaborates with other managers, physicians, administration, and community based healthcare workers regarding care management issues identified through corporate or facility initiatives and current literature.
- Works closely with all departments at the medical center and the post-acute service providers to streamline the patient transition through the health care system and into the community post discharge.
~LI-DH
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Position Summary: Responsible for leading, planning, directing, monitoring and improving the overall performance for assigned clinics to achieve excellence in the delivery of daily operations. Engages staff and cultivate a positive clinics culture that prioritizes humankindness and patient-centric care. Accountable for operational, financial, clinical, quality, and business development activities across multiple disciplines. Principal Duties and Accountabilities:
- Oversees the development of assigned clinics and regularly manages improvement projects and is accountable for operational, financial, and business development activities.
- Develops, analyzes, and implements processes and systems to enhance customer service across assigned clinic(s) and takes ownership of and drives needed improvement in all aspects of operations, including clinic productivity, patient satisfaction/experience, provider satisfaction/experience, community efforts and serves as the local representative for the area.
- Responsible for financial management of the assigned clinic's financial operation budgets, including forecasting gross and net revenues, visit projections, and expenditures.
- Plans, coordinates and effectively leads assigned clinics to meet patient care, administrative, operational, and support requirements.
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Position Summary: Responsible for leading, planning, directing, monitoring and improving the overall performance for assigned clinics to achieve excellence in the delivery of daily operations. Engages staff and cultivate a positive clinics culture that prioritizes humankindness and patient-centric care. Accountable for operational, financial, clinical, quality, and business development activities across multiple disciplines. Principal Duties and Accountabilities:
- Oversees the development of assigned clinics and regularly manages improvement projects and is accountable for operational, financial, and business development activities.
- Develops, analyzes, and implements processes and systems to enhance customer service across assigned clinic(s) and takes ownership of and drives needed improvement in all aspects of operations, including clinic productivity, patient satisfaction/experience, provider satisfaction/experience, community efforts and serves as the local representative for the area.
- Responsible for financial management of the assigned clinic's financial operation budgets, including forecasting gross and net revenues, visit projections, and expenditures.
- Plans, coordinates and effectively leads assigned clinics to meet patient care, administrative, operational, and support requirements.
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Job Summary / Purpose
Serves as the leader and subject matter expert for the CommonSpirit Health Centers of Excellence Leave Management program. This position will be responsible for setting strategic direction, leadership, and implementation, while ensuring all leaves of absence programs under the COE support the overall business and delivery strategy with a focus on employee engagement. In addition, collaboration with key stakeholders to ensure compliance with all regulatory and contract requirements for healthcare organizations.
Essential Key Job Responsibilities
1. Serve as the primary subject matter expert for CommonSpirit Health leave programs under the COE, ensuring all programs support the overall business and benefits design and delivery strategy.
2. Oversees all policy design and development that integrates with the leave programs, legislative and legal requirements, and union contract requirements while supporting strategic business decisions.
3. Integration and implementation of an in-sourced delivery model which includes evaluation of current programs, development of required workflows, claim correspondences, and training content.
4. Development of performance metrics, service level agreements and quality assurance of programs.
5. Develop, monitor and report program performance measurement strategies against data analytics to understand key cost drivers, trends, optimization opportunity, and improvement of employee experience.
6. Vendor management and oversight for design and process changes. Serves as point of contact for escalations.
7. Actively manage vendor relationships by continually reviewing and assessing contracts and service level agreements to ensure efficiency and effectiveness.
8. Prepare and present recommendations to HR leadership relating to new leave programs or standardization or changes to current leave programs.
9. Develop formal Return to Work guidelines and tools in partnership with HR Operations and vendor(s).
10. Develop a formal ADAAA process establishing accommodation opportunity across varying job functions, while ensuring compliance of the program with both processes, policies, state and federal law. Improve stay-at-work and early return-to-work opportunity.
11. Develop strategic partnerships and collaboration with COEs, HR leadership, business partners and vendor(s) to achieve directed COE state.
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Position Summary: Directs operations related to the clinical laboratory. Provides overall direction to laboratory managers/supervisors. Creates alignment with hospital staff, department directors, and physicians to foster open communication. Oversees all workflows to maintain the highest standard of quality and service. Prepares and manages the budget for costs related to the clinical laboratory. Principal Duties and Accountabilities:
- Works closely with hospital staff, department directors and physicians to ensure that the highest standards of quality and service are maintained.
- Writes and updates procedures and manuals as needed; reviews employees annually to ensure they have current information needed to perform tests and procedures.
- Manages, updates and takes responsibility for the quality of laboratory work processes.
- Prepares the laboratory budget for costs such as personnel, equipment, supplies and consumables, and ensures adherence to it.
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Position Summary:Leads and sets strategy for mission integration within Dignity Health to ensure the mission, vision, values and heritage are integrated into all aspects of the organization. Promotes a values-based organizational culture uniting people around the organization's mission, vision, values, and heritage. Designs and implements educational programming for staff, medical staff, volunteers, the community, and others about the Dignity Health mission, vision, values, and heritage.
- Sets strategy and works with the leadership team to make operational the Dignity Health Mission Integration Standards. Develops and implements processes that affect the organization's operations, goals and strategic transformation.
~LI-DH, #Chaplain
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Position Summary: Directs the provision of nursing care in a business unit while maintaining standards of patient care. Principal Duties and Accountabilities:
- Responsible for the overall quality of care provided by the nursing personnel. Advises medical staff, department heads, and administrators in matters related to nursing service and strategies.
- Interprets policies and objectives of nursing service to staff and community groups.
- Monitors the operations of the nursing staff and ensures compliance with regulations on organizational and governmental standards and practices. Schedules staff and conducts employee performance reviews.
- Provides nursing care to patients on an as needed basis.
#HelloEmergencyLeader
tb2019
#RN@DH
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Overview:
Directs the provision of nursing care in a business unit while maintaining standards of patient care.
Responsibilities
- Responsible for the overall quality of care provided by the nursing personnel. Advises medical staff, department heads, and administrators in matters related to nursing service and strategies.
- Interprets policies and objectives of nursing service to staff and community groups.
- Monitors the operations of the nursing staff and ensures compliance with regulations on organizational and governmental standards and practices. Schedules staff and conducts employee performance reviews.
- Provides nursing care to patients on an as needed basis.
surgery, operating room, or, perioperative services, perioperative, surgical services, periop, rn, nurse, staff nurse, registered nurse, charge nurse, supervisor, lead, circulating, scrubbing, operating theater, aorn, cnor, director, manag
#HelloSurgicalServicesLeader
#RN@DH
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Position Summary: Responsible for setting the strategic direction for, and oversight of, management and budget accountability of the Spiritual Care department. Integrates program structure into overall hospital strategic plan including patient and family care and spiritual support for staff. Principal Duties and Accountabilities:
- Works within an interdisciplinary team in caring for the holistic needs of the person. Leads and sets strategy for the department in providing religious, spiritual, ethical, emotional support and pastoral counseling for patients, their families and staff.
- Leads and sets strategy for the spiritual development of the organization including spirituality in the Workplace. Develops educational programs for internal and external groups on spiritual and religious care. Demonstrates and assesses chaplain competencies and responsibilities and assures scope of practice evolves with changing organizational needs.
- Develops and implements strategy, policies and procedures relevant to Spiritual Care. Directs the department's involvement in spiritual care services, advanced directives, bio-ethics, palliative care, and advocacy regarding patient rights issues and employee satisfaction.
- Designs and implements systems supporting organizational ethics and compliance with regulatory requirements, ensuring department and staff remain compliant.
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*This is a remote position that may sit anywhere in the US - Travel Required.Job Summary / Purpose
Responsible for the management of CHI’s national operations optimization initiatives. Leads the implementation of high-value initiatives that help CHI Integrated Supply Chain accomplish its strategy. Builds standard operating procedures designed to enhance controls and efficiency while establishing optimal data capture to facilitate centralized approaches to advanced analytics. Responsible for developing audit programs and metrics to ensure that standards are adhered to and performance expectations are met. Identifies key sources of value in operations and provides direction to market leaders to optimize value capture. Acts as a critical connection point to integrate operations with procurement and contracting.
Essential Key Job Responsibilities
- Develops and leads an audit program to ensure compliance to standard operating procedures
- Enhances operational procedures to be more effective and efficient
- Contributes to the design of operational processes and transactions such that the data captured is standardized and reliable for large scale analytics
- Collaborates with leaders in Procurement and Contracting to optimize CHI’s utilization of contracts
- Quantifies the impacts of operational improvements in financial terms and helps to determine the best deployment of resources to obtain the optimal outcome
- Directs market supply chain leaders to key sources of opportunity and provides direction on the most effective methods to achieve the value
Non-essential Job Responsibilities
- Other duties as assigned by management
- Enter additional item as applicable
~LI-DH
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Position Summary: Under the direction of the senior director, leads the facilities Care Coordination and Social Services, including but not limited to clinical resource management, discharge planning activities, patient advocacy, clinical social work and best practice in medical necessity determination and concurrent review. Principal Duties and Accountabilities:
- Directs and manages areas including planning, organizing and directs all activities, staffing, performance improvement in the delivery of clinical services (such as LOS reduction). Reports needs within the Medical Center and Dignity Health, as well as government and regulatory reporting.
- Guides Care Coordination activities according to the needs, requirements, and policies of the Medical Center, the affiliated medical groups and health plans, Dignity Health, any Federal and State agencies, and according to standard practices of the professions under the director's accountability.
- Consults and collaborates with other managers, physicians, administration, and community based healthcare workers regarding care management issues identified through corporate or facility initiatives and current literature.
- Works closely with all departments at the medical center and the post-acute service providers to streamline the patient transition through the health care system and into the community post discharge.
Registered Nurse, RN, Sr. Director, Director, Case Management, Case Manager, Care Coordination, Utilization Management, UM, Arizona license, BSN, MSN, 3 years leadership, Acute Care, #CMleader #RNcarecoordinationleader
