Lead District Health Services Administrator

JOB SUMMARY: Supporting the Director of Patient Services (DOPS) in providing leadership to the Health Center regions that contribute to the mission, vision, and strategic plan. The lead DHSA is a seasoned and experienced individual who has strong leadership and critical thinking skills to provide overall administrative direction and oversight, to other DHSAs, for policies, procedures (workflows), and programs of multiple ambulatory health centers. The lead DHSA will fill in for the Director of Patient Services, as needed, and will represent Omni at meetings with external organizations as assigned by the DOPS. The lead DHSA will not conduct yearly evaluations to other DHSAs, will not perform disciplinary actions to other DHSAs; they will only supervise, instruct/train and direct other DHSAs as directed by the DOPS.

Will supervise other DHSAs and ensure the day-to-day operations are performed efficiently, in accordance with Omni Family Health (OFH) policy and procedures, for their assigned Counties. Collaborates with external resources and DHSAs to proactively problem solve and continuously improve the services delivered at OFH. Analyze, develops, and monitors processes and reports trends affecting OFH; provides strategic action plans for the health center, staff, and follows through with implementation, monitoring and reporting on all center business objectives to the DOPS on a weekly, monthly, or as needed, basis.

Each County should have a Lead DHSA who is responsible for supervising the complete health center operations and supervising DHSAs. Counties are defined as health centers located in a specific area within Kern and northern Counties (Tulare, Fresno, and Kings County or other counties).

JOB DUTIES:

General:

• Consistently evaluate and streamline operational functions:
• Support the DOPS by making sure tasks/projects assigned to other DHSA are completed accordingly and on time.
• Make recommendations to DOPS for trends affecting the health center's operations and provide an action plan to improve any negative trends.
• Serve as the main point-of-contact between DHSAs, Health Center Managers (HCM), and Front Office Clerks (FOC).
• Strive for excellence and always look for an opportunity to make an improvement.
• Re-evaluate processes previously implemented to identify further ways of improving.
• Identify ways to streamline in terms of time efficiency and cost effectiveness.
• Foster inter-Network collaboration with colleagues to identify areas of improvement and brainstorm ways of improving operational functions and develop framework for discussion and implementation.
• Oversees the establishment and implementation of operating policies and procedures for OFH.
• Maintain the basics at all times:
• Service Excellence
• Patient and Employee Satisfaction
• Compliance/Continuous Quality Improvement
• Read and respond appropriately to all applicable reports; develop and implement corrective action plans for areas needing improvement (e.g. wait times, no shows, etc.).
• Business Services/Data Entry Integrity such as:
• Co-Pay & Payment Collections - meet goal of 80%
• Patient demographics (e.g. address & phone)
• Denials & IBGs
• All Error-related Reports - to be eliminated
• Sets the tone for a positive, supportive work environment. Be operationally sound and interactive, a visionary strategist as well as a hands-on operational leader who works together with the physicians, upper management, DHSAs, front line managers, and staff.
• Provides leadership, administrative direction and coordination in the formulation, interpretation and administration of current and long-range policies, procedures and programs for multiple ambulatory health centers throughout OFH.
• Assists DOPS in ensuring Center adherence to regulatory and grant requirements.

Assist in long range planning by advising DOPS of current clinical operations and market developments and contributing ideas for new services/programs.

Staff Management

• Hold DHSAs accountable fairly, equitably, consistently and timely, and in accordance with policies:
• DHSAs coaching and training should be done timely; training documentation should be maintained in the DHSA's HR records.
• Support DHSA's competency and accuracy of health center responsibilities and functions:
• When conducting competency assessments, ensure the DHSA can clearly demonstrate knowledge in specific function (e.g. can actually perform job duty - that staff understands it and performs it as part of their performance evaluation).
• Responsible overall for DHSA development. Provides instruction, explanation, and a program of training in tasks and techniques for upgrading of the DHSA's skills as required.
• Maintain a global view of the health center at all times:
• Facility (internal and external)
• DHSAs (support staff competencies & conduct)
• Providers (provide adequate support & communicate regularly with them)
• Patients (ensure their needs are met, interact with them)
• Processes (are they being followed, are they redundant, efficient, meaningful, can it be done better/differently?)
• Works closely with other DHSAs to ensure that all billable services are submitted for processing promptly; avoid denials to occur.

Quality Management & Reporting:

• Provides monthly reports to the DOPS on health center's workload statistics, staffing, accomplishment and challenges. In collaboration with the DOPS, conducts an annual evaluation of the total program including a review of utilization of services, a sample review of patient records to support continuous quality improvement, and a review of policies and procedures.
• Effectively monitors profitability and reports shifts/changes, patient/exam volume, payer mix, productivity by physician, and related practice analysis data.
• Implement and integrate the quality assurance recommendations by the DOPS. Ensures that center QI activities are conducted in accord with the corporate QA plan. Plans and directs ongoing customer focused quality improvement activities.
• Follow through with implementation, monitoring and reporting on all center business objectives, examples include but are not limited to: referral for patients not served, waiting lists and times, grievances & complaints, discharge planning and record closures, QA/QI outcomes, new patient placement, eligibility, and involuntary discharges, patients served by program, treatment and quality of services, and any other pertinent statistics used to run health center.

Additional Functions and Responsibilities:

• HIPAA compliance - Responsible for maintaining abreast of and in compliance with all HIPAA regulations and requirements. Treats all member information confidential.
• Compliance - Ensure compliance with all local, state and federal regulations.
• QA/QI - Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.
• IT - Required learning and using the EHR/EOHR (Medical Practice Electronic System) and its components. As required by the job functions and highlighted in the Policies and Procedures. These components include NextGen, Healthport, PMS, QSI and other electronic features, as they are developed and implemented, as applicable to work environment.
• Promotes and believes in OFH mission
• Other related duties as directed by the DOPS. The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
• Delegation of Responsibilities:
• The responsibility of the Lead DHSA for these functions and policies does not require the individual to perform every function or write every policy personally. However, delegating a function does not relieve the Lead DHSA of responsibility for the content of each policy and the performance of the health center and the staff being in compliance with applicable law.
• The Lead DHSA does not have to be in charge of general, higher-level financial functions, such as budgets, finance, accounting, cash flow, profit and loss, assets and liabilities. But when the decisions of those in charge of the financial functions of the facility do not comply with policy, the Lead DHSA must take action to correct this conflict.

QUALIFICATIONS:

Knowledge, Skills, and Abilities: General knowledge of accounting/bookkeeping, budget projections, personnel management, policy development, data analysis, and supervision needed.

Special Skills:

• Must have knowledge of current CPT and ICD-9/10 coding.
• Must understand the billing procedures for Medicare/Medicaid, Workers Compensation, HMOs, PPOs and other managed care and commercial insurance plans.
• Working knowledge of computerized medical office software, especially Electronic Medical Records, required: knowledge of NextGen software preferred.
• Ability to read, understand and follow oral and written instructions. Two to five years direct supervisory experience in a similar setting.
• Bilingual capability helpful; must have good interpersonal skills; must have flexibility and ability to juggle many obligations and set priorities.
• Strong leadership and organizational skills.
• Able to work flexible hours as needed

Ability to:

• Plan, organize, direct, supervise and evaluate outpatient medical health centers and ancillary services.
• Design and deliver in-service training programs.
• Assume a leadership role in the community's health delivery system.
• Analyze, evaluate and solve complex administrative problems.
• Understand, interpret, explain and apply laws, regulations, policies and written and oral directions.
• Supervise, train and evaluate the work of subordinate staff.
• Write effective and comprehensive reports and recommendations.
• Make oral presentations to small and large groups of diverse audiences.
• Prepare and analyze grant proposals, service contracts, budgetary documents and financial statements.
• Establish and maintain cooperative working relationships with staff, representatives of community organizations and the public.
• Input, access and analyze data using a computer terminal.
• Interpret organization policies, programs and procedures to others.
• Coordinate organization meetings, staff meetings and conferences

Special Requirements/Conditions: Ability to provide suitable transportation

EDUCATION AND EXPERIENCE:

Bachelor's degree in business or healthcare administration or relevant degree required. Master's Degree preferred. 2-5 yrs direct supervisory and management experience in a Federally Qualified Health Center (FQHC) facility. Years of experience can be substituted on a year-by-year basis for academic training.

RESPONSIBLE TO: Director of Patient Services (DOPS)

CLASSIFICATION: Exempt