Director of Clinical Operations, Regional Women's Services & Pediatrics (RWSP)

Job Summary:

The Director of Clinical Operations of the Regional Women's Services and Pediatrics (RWSP) Program Clinical Operations reports to the Chair of Obstetrics and Gynecology with a dotted line to the Sr. VP of Ambulatory Operations of the UTMB Health System the Chair of Pediatrics. The Director is responsible for the direction, leadership and day-to-day operations of clinical operations for RWSP, Women Infants and Children (WIC) and Maternal Fetal Medicine Ultrasound (MFMUS).  The Director profiles the vision and the leadership to meet the goals and objectives of UTMB’s mission and strategic plan. This position demonstrates the professional skills and behaviors to promote comprehensive, cost effective and patient-focused integrative care for patients in a unique and diverse health environment in collaboration with Ambulatory, OB/GYN, and Pediatric leadership.

Scope: Has direct oversite over day-to-day RWSP clinical practices operations, compliance, safety, and quality of care and process improvement

Essential Job Functions:

• Works with the physician Medical Directors and Chairs of Ob/Gyn and Pediatrics to revise and update the RWSP Provider Practice Guidelines as necessary to reflect the current standard of care and ensure the provision of high quality, high value care.
• Provides leadership and participates in strategic development of short-term and long-term planning, as well as program development for RWSP, WIC and MFMUS
• Provides direct supervision of the RWSP Regional Directors including WIC services and MFMUS
• Closely monitors and maintains records for prescriptive authority of all RWSP providers. Monthly, accompanies Vice Chair of Pediatrics to conduct on-site reviews of compliance.
• Closely monitors and maintains records for prescriptive authority of all RWSP Women’s and Pediatric providers.
• Stays abreast of state legislative changes for advanced practice and communicates changes to providers and leaders. Ensures all APP providers are practicing within the scope of their licensure.
• Works with the Director Administrative Operations of the RWSP to sustains solid relationships with county agencies. Travels to meet with various county judges (ex: Orange, Brazoria, New Caney) to communicate any changes in RWSP leadership and ensure that the county is aware of new RWSP initiatives as needed.
• Works as a dyad partner with Director of Administrative Operations of RWSP to communicate any policy changes that have material impact to RWSP staff and clinicians.
• Manages and monitors clinical volumes, and access metrics as well as financial and statistical performance against budged targets
• Collaborates with Director of Professional Practice for Ambulatory Operations to ensure appropriate nursing standards are met in all RWSP clinics and MFMUS
• Supports patient safety activities within clinical areas and participates in leadership patient safety rounds
• Provides verbal and written reports on a regular basis regarding overall activities, performance and goals
• Ensures the appropriate amount and type of staffing of practitioners and support staff to meet the planned and budgeted goals and ensures a competent and productive labor force
• In collaboration with Director of Administrative Operations and ambulatory directors, determines, monitors and ensures that productivity and utilization goals are met for all clinics
• Maintain quality patient care and service by planning and developing programs to ensure compliance with established County, State and Federally mandated policies and procedures, including licensing and accreditation programs
• Identifies new practice opportunities and other clinical activities that support the mission and success of RWSP, WIC, MFMUS, and the Health System
• Works with inpatient, Labor & Delivery, and other outpatient services to assure seamless operations between the inpatient and outpatient environments
• Works with management team and medical leadership, serving as a resource to help reduce costs, enhance revenues, achieve effective utilization and quality goals and objectives, analyze and utilize information to develop and support management decisions
• Provides leadership in developing, communication and supporting operations to ensure quality care is available to patients and appropriate standards of care that meet national, state and local rules and regulations are maintained
• Assists clinical leadership in developing annual clinic budgets; investigates and implements methods of controlling costs, maximizing revenue and maintaining a balanced operating budget
• Develops, analyzes, interprets data to identify trends, assess medical services use, cost effectiveness of care, helps establish productivity measurements
• Continually provides oversight and reporting to senior executive leadership, and any potential irregularities indicating potential fraud and abuse activities
• In concert with the Director of Administrative Operations and Director of Professional Practice for Ambulatory Operations and UTMB Compliance Office, develops a compliance plan for the RWSP operations
• Works with Compliance Officer and staff providing mechanisms to monitor and enforce compliance with specific regard to state, federal and other laws, regulations, and requirements as they relate to professional fee billing
• Meets regularly with Sr. VP of Ambulatory, Chair of OB/GYN and Chair of Pediatrics to discuss goals, initiatives and progress
• Creates a work environment that fosters teamwork, cooperation, innovation, open communication and respect
• Adheres to internal controls and reporting structure.
• Performs related duties as required.

Knowledge/Skills/Abilities:

• Strong clinic and business acumen and be able to analyze data and financials and apply to decision-making
• Comfortable with shared accountability for revenue cycle management
• Creates operational and organizational infrastructure that maximizes the effectiveness of each RWSP and WIC site
• Comprehends the rules and regulations, current and pending, which impact health care financing and reimbursement
• Detailed knowledge and understanding of Texas Medicaid Program and Texas Medicaid Managed Care, as well as related Federal and State standards
• Detailed understanding of Texas Advanced Practice Provider standards and licensing requirements
• Knowledge of Joint Commission requirements and guidelines
• Experienced in establishing and attaining KPIs in areas such as patient satisfaction and access
• Comfortable with diversity of individual specialty practice needs, while creating commonality of culture and process
• Collaborates with Sr. Vice President of Ambulatory Operations, Chair of OB/GYN, and Chair of Pediatrics to create an innovative staff development plan that focuses on recruitment, retention and growth of advanced practice nurses
• Strategic orientation and focus
• Astute intellect
• One who can respect and honor the past while transforming the present
• Respect for, and commitment to, appropriate transparency
• Capacity to inform and appropriately influence
• Develop an effective team that also highly values relationships and productivity
• Collaborative by nature
• Available to support and develop direct reports
• Ability to create mutually productive, respectful and trusting connections internally and externally
• Respected for their ability to relate with diverse individuals
• Promotes a culture of “Service Excellence”
• Diplomacy
• Possesses a sense of humor and positive attitude; an enthusiastic disposition and high energy level
• Is flexible, has a tolerance for ambiguity and is not easily frustrated; understands that success is often achieved through incremental steps
• Ability to bring disparate groups, goals and objectives together under one operating “umbrella”