Reimbursement Services Director jobs in Louisiana

Description

Position Summary

The Director of Clinical Services supports the Chief Operating Officer in providing support for al clinical functions at assigned facilities to ensure all client facilities operate in compliance with current federal, state, and local standards, guidelines and regulations that govern individual facilities; and in accordance with policies and procedures as may be promulgated from time to time; and as otherwise directed to promote the highest degree of quality resident care at all times.

Position Responsibilities

The Director of Clinical Services provides oversight, guidance and advice and support, evaluation and remediation, and training and follow-up to appropriate staff at assigned facilities and nurse consultants in the areas of survey process, resident assessment, nursing documentation, medication management, nursing budgeting process to include staffing levels and calculation and monitoring of nursing hours per patient day, infection control, restraint reduction, weight variances, safety, fall prevention, quality assurance, PPS (Medicare(, pressure ulcer prevention, and care planning in conjunction with the executing management team as it relates to frail geriatric residents and patients in the long-term care industry.   Responsibilities of the Director of Clinical Services include (but are not limited to): 

• Promotes and maintains a focus of patient-centered care
• Adheres to laws, rules & regulations and practices ethical integrity and interpersonal skills
• Maintains compliance with long-term care regulations including federal, state and health regulations
• Responsible to the Chief Operating Officer for the successful  development and strategical implementation of the clinical services program
• Has strong  abilities in enforcing laws, rules & regulations, ethical integrity and interpersonal skills
• Supervises over-all performance of assigned nurse consultants and provide orientation and on-going training programs to increase each consultant’s knowledge levels and assist each with staying abreast of changes within the healthcare arena and regulatory environment
• Monitor trends for assigned facilities based on available information to include quality indicators, payroll variance reports, clinical indicators, 2567 reports, mock survey findings, and consultant visits. Uses such information to formulate plans for policy and procedure development, educational needs, establishes appropriate goals and approaches to address findings.
• Conduct routine facility rounds and medical record reviews to assess quality and appropriateness of care provided and compliance with accepted nursing standards and policies and procedures.
• Verify client facilities have working committees, including but not limited to: Infection Control, Restraint Reduction, Weight Variance, Safety, Fall Prevention, Quality Assurance, PPS (Medicare), Pressure Ulcer Prevention, and Care Planning. Assist with development of such committees as needed. 
• Monitor facility-staffing patterns for compliance with federal and state regulations and company policies and procedures.
• Coordinate, develop, and deliver on-going training programs for nursing services personnel at all assigned facilities
• Monitor facility compliance with policies and procedures related to ordering equipment and supplies, related budgetary compliance, and maintaining adequate supply levels to meet resident needs.
• Monitor facility compliance with policies and procedures related to ordering equipment and supplies, related budgetary compliance, and maintaining adequate supply levels to meet resident needs
• Verify nursing assessments capture appropriate information to support the highest RUG level, PPD and/or case mix level for each resident
• Provide support and education to all new facility nursing services personnel to include the Director of Nursing Services, Assistant Director of Nursing Services, and MDS/Care Planning Nurses
• Provide support and education to all new facility nursing services personnel to include the Director of Nursing Services, Assistant Director of Nursing Services, and MDS/Care Planning Nurses 
• Prepare nursing status reports for each facility as required
• Function as Director of Nursing Services as required
• Function as Nurse Consultant in areas without a Nurse Consultant as required
• Perform position duties in a manner as to assure resident safety and rights are priority
• Adheres to the facility corporate compliance program and promotes the program in a positive and effective manner
• Performs other position-related duties as assigned, depending on assignment/shift setting

Other Responsibilities

• Follows facility OSHA safety rules and procedures
• Follows facility policies and procedures and adheres to federal and state regulations for long-term care
• Respects cultural and religious practices of patients
• Upholds HIPAA regulations
• Maintains a punctual and dependable attendance record

Position Requirements

• Bachelor of Science Degree in Nursing (BSN) from an NLN accredited college or five (5) years of long-term care nursing experience
• Prior nursing experience preferable in Long Term Care 
• Unencumbered license as a Registered Nurse in all states where assigned in good standing
• Federal, State, and MHI required credentials current and on file
• Cognitive skills as related to the position

Working Conditions

Because the nursing home provides round-the clock care, working hours may include days, nights, weekends and holidays.  The Director of Clinical Services works in a climate controlled and well-lighted environment with a smoke-free policy.  Works in an office and walks throughout the building daily.  Has a low risk of exposure to infectious diseases, but receives training in handwashing practices and has access to personal protective equipment if direct exposure is anticipated.  Is subject to interruptions, noise, and odors daily.  

Physical Demands

• Long periods of sitting at a desk and working on computer.  Prolonged periods of standing, bending, and reaching
• Lifting and carrying continuously.  The ability to lift up to twenty (20) pounds occasionally.  Assistance in moving, lifting or transferring of patients may involve lifting of up to fifty (50) pounds occasionally.  
• Fine motor skills
• Visual acuity

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job.  While performing the duties of this job, the employee is regularly required to stand and talk or hear.  The employee is frequently required to walk; use hands to finger, handle, or feel; and reach forward with hands and arms.  The employee is occasionally required to sit and stoop, kneel, or crouch.  The employee must occasionally lift and/or move up to 20 pounds and occasionally lift or move 50 pounds.  Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.  

Physical Demand Ratings are an estimate of the overall strength requirements that are consider to be important for an average, successful work performance of a specific job. The overall physical demand rating for a Director of Clinical Services falls within the medium classification (10 to 20 pounds of force occasionally and/or exerting 20 to 50 pounds of force occasionally.  Physical Demand requirements are in excess of those for Light Work.