Responsibilities

Job Summary:

Responsible for direct operational management of Employed Provider Network (EPN); to include effective management of human, financial, and environmental resources. Provides direction and leadership to the practice managers by setting goals and monitoring progress. Heavily focused on quality improvement through creating and operationalizing population health initiatives for the EPN. Provide expertise to acquire, manage, manipulate, and analyze metrics for the EPN. Provides oversight and performance management to the EPN Managers and Quality staff. Requires having the interpretation skills necessary to communicate reports and information for a variety of stakeholders including physicians, administrative staff, and EPN leaders.

Promotes collaborative practice with hospital departments, physicians, and leadership. Exhibits ability to work with others to identify and implement solutions to difficult human, technical, and administrative problems. Must be able to adjust to and lead others through rapidly changing environment while demonstrating emotional and professional intelligence.

Demonstrates through behavior Decatur Morgan Hospital’s mission, vision and values.

Qualifications

Minimum Knowledge, Skills, Experience Required:

Education:

Bachelor's degree in Hospital Administration or related field required. Masters preferred.

Experience:

Must have a minimum of five years management experience.

Additional Skills/Abilities Required:

· Skilled in developing effective collaborative relationships with providers.

· Ability to establish a course of action for self and others to accomplish a specific goal.

· Demonstrate critical thinking and analysis skills.

· Possess ability to communicate clearly and professionally.

· Ability to react calmly and effectively in all situations.

· Ability to maintain confidentiality of sensitive information

Key Responsibilities / Essential Functions

1. Directs operations of the EPN.

2. Guides the strategic planning for the EPN in coordination with the SLD and Administration.

3. Serves as the internal expert on population health management.

4. Responsible for meeting strategic goals through performance improvement initiatives, cost reduction, and volume expansion.

5. Helps to set annual quality goals for physicians based on EPN and hospital goals.

6. Provides direct oversight and mentorship to clinic managers.

7. Acts as the liaison between IT Ambulatory Support and the clinics.

8. Manages and oversees the EPN Quality Supervisor and Wellness Nurse(s).

9. Participates in monthly calls/meetings with payors and ACO.

10. Coordinates with ACO for compliance and participation requirements.

11. Focused on the population health management performance within the ACO and all other managed care payor populations.

12. Work in tandem with managers and quality staff to drive population health initiatives.

13. Oversee creation of population health education for providers.

14. Review ACO scorecard quarterly with managers, SLD, VP of Operations to update hospital goals.

15. Oversees the annual employee evaluation process to ensure timely completion and submission by the managers.

16. Reviews and updates job descriptions as needed.

17. Monitors, and ensures compliance with the budgets of the Provider Network.

18. Works with clinic managers and SLD to prepare annual budgets for all employed clinics.

19. Oversees the monthly revenue cycle meetings with hospital admin and billing companies.

20. Assists with new clinic startup and acquisition, as needed.

21. Works with Billing on payor, provider, and clinic credentialing.

22. Understands employment contracts and compensation structures including using MGMA and/or other data banks to build pro-formas and determine fair market salaries.

23. Prepares quarterly bonus payments for network providers in compliance with their pay model.

24. Prepares annual salary adjustment proposals based on provider’s prior performance.

25. Recruits Nurse Practitioners and/or Physician Assistants and/or Midwives to accommodate growing demand for healthcare access.

26. Responds to physicians, administration and other departments on matters concerning departments under direct supervision.

27. Enforces hospital/department policies and procedures.

28. Ensures compliance with JCAHO requirements and all federal and state regulations.

29. Other duties as assigned.