Oversees clinical operations to ensure delivery of high-quality, compliant, industry-leading hospice care that delivers an excellent consumer experience and makes a difference in the lives of the patients and families we serve in our communities. Leads overall planning, directing, monitoring, and reporting on, all patient care activities within the budget capabilities of the hospice program. Models VNS Health values and ensures the delivery of consistent high-quality patient care that complies with Medicare Conditions of Participation and state and federal regulatory requirements and ensures an excellent consumer experience. Serves as key member of the VNS Health leadership team and is responsible for promoting positive working relationships within the company, among all departments, and all external stakeholders.

$193,600.00 - $258,200.00 Annual

• Oversees the development and implementation of clinical quality and compliance processes to ensure the provision of consistent, high-quality, and compliant hospice care across the organization.
• Provides program oversight for all day-to-day functions related to patient/family care services and any/all issues related to assuring high care quality, services monitoring, services documentation thereof and maximum utilization of all care related resources and related costs.
• Builds relationships with leadership and teams throughout the organization for full collaboration to achieve strategic objectives.
• Analyzes quality metrics to identify trends and proactively address clinical services and report patient/caregiver experience performance.
• Monitors utilization of clinical services resources to maximize reimbursement opportunities and minimize denial of reimbursement.
• Collaborates and coordinates with Inspire executive leadership to develop and execute clinical strategies and initiatives that advance the Inspire Hospice mission and vision.
• Oversees the development and implementation of clinical training and development programs for clinicians.
• Monitors care provided by the clinical team and clinical leadership processes to ensure teams meet clinical quality performance s and provide excellent end of life care.
• Acts as a resource for office and regional leadership, offering expertise on Medicare conditions of participation, company policies, and clinical best practices.
• Oversees and participates in initiatives to manage utilization of medical supplies, durable medical equipment, travel, etc.
• Participates in finance discussions and Pre-Bill compliance and unbilled outcomes.
• Ensures that all Conditions of Participation, state and federal regulatory standards and Standards of Care are being met, as per corporate policy and procedure and reporting variances or concerns to the Hospice leadership and compliance in a timely manner.
• Participates in the development and administration of policies regarding clinical and business operations.
• Ensures that appropriate levels of care/service are regularly monitored and is adjusted by current acuity for all hospice patients, by working closely with and through the Chief Medical Officer and other hospice clinical leadership reporting to senior management in a timely manner.
• Serves as the program's primary liaison to ancillary vendors (pharmacy, DME, lab, therapies, etc.), reporting service variances or concerns to leadership and Contract Management Department.
• Collaborates with leadership and departments across VNS Health to assure clinical excellences outcomes and monitor all hospice expenditures in accordance with the program's budget.
• Ensures compliance of the clinical services department with state and federal regulations for hospice and palliative care, as well as with CHAP standards to assure adherence to excellence in patient care.
• Attends and participates at organization functions which relate to community and public awareness.
• Performs all duties in a senior managerial role. Approves staff training, hiring, promotions, terminations and salary actions, prepares and ensures adherence to the Department budget.
• Participates in special projects and performs other duties as assigned.

Licenses and Certifications:

• License and current registration to practice as a registered professional nurse in New York State required
• Hospice and Palliative Care certification preferred
• Hospice Administration certificate preferred

Education:

• Bachelor's Degree in Nursing from an approved program required
• Master's Degree in Nursing, business or health administration preferred

Work Experience:

• Minimum of eight years in a hospice program with emphasis on clinical operations, quality, and compliance required. Minimum of three years of multi-site hospice clinical or operational management required
• Minimum two years experience participating in state surveys and the accreditation process (i.e., JCAHO, ACHC, CHAP) preferred
• Knowledge of Medicare conditions of participation, hospice federal and state regulations, clinical practice and billing requirements (CTI's, Plans of Care, IDG, Face to Face, etc.) required. Knowledge of CHAP Hospice Standards preferred
• Must be knowledgeable of hospice payor audits including ADRs, ZPICs, UPICs, etc. preferred
• Demonstrated ability to resolve conflict, motivate staff and interact with superiors, peers and subordinates in a direct and professional manner required
• Demonstrated ability to solve problem and make independent judgments and decisions based on experience and good judgment required
• Proficient with MS Office products (Word, Excel, PowerPoint, Visio required
• Excellent verbal and written communication skills required
• Excellent interpersonal skills required