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Director of Clinical Operations

Indianapolis, IN, United States

The Director of Clinical Operations is responsible for providing clinical leadership for PPHP’s Institutional Special Needs Plan, a Medicare Advantage Special Needs Plans for long term care nursing facility residents. The Director is responsible to achieve optimal clinical operations, processes and clinical metrics, and operational efficiencies while adhering to the Institutional Special Needs Plan (I-SNP) Model of Care and other regulatory and accreditation guidelines.

The Director of Clinical Operations oversees a team of Provider Partners Health Plan Nurse Practitioners (NPs) and RN Care Coordinators (RNCCs) that collaborate with network-based attending physicians and clinical staff at skilled nursing facilities. The objective of the I-SNP is to work with these clinicians to deliver excellent care that avoids unnecessary acute admissions through proactive preventive care delivered at the skilled nursing facility. The Director of Clinical Operations will implement the clinical model for the program. This role will include time in the field meeting and communicating with business and clinical leadership at contracted nursing facilities and network attending physicians. This position has a strong ambassador element for the health plan and will require travel to contracted facilities within the region.

Responsibilities include:

Design, development, and implementation of strategic initiatives for Clinical Operations in the I-SNP across the region.

Completes corporate level development and support related to training, standard operating procedures, financial management, data reporting, compliance, project management, and process improvement to achieve overall organization goals.

Participates in budget & financial management of related / assigned projects & activities.

Coordinates financial & operational oversight for all I-SNP clinical activities in the region.

Supports functions such as NP/RNCC auditing, document management, Stars/HEDIS, and policies & procedures.

Support compliance related to CMS and applicable external accreditation/recognition programs.

Manages staff and completes all related HR functions, hiring, terminations, and employee evaluations.

Masters prepared adult, family or geriatric Nurse Practitioner.

A minimum of five years’ experience in a clinical health care setting.

Minimum of three years management experience.

Must be positive, enthusiastic and highly motivated.

Must be flexible and adaptable to working in a fast-paced, dynamic environment.

Preferred qualifications

3 years’ experience in a leadership role in the LTC setting

3 years’ experience leading clinical operations in an Institutional Special Needs Plan

Previous experience implementing large scale clinical programs and teams

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