Total 11 Director/C-Level Health / Beauty / Fitness job vacancies in Philadelphia, Pennsylvania

Duties include but not limited to:

The following is a summary of the major essential functions of this job. The Incumbent may perform other related duties as assigned, both major and minor not mentioned below; periodically specific functions may change.

• The incumbent supervises staff that range in grade from the GS 9, Assistant Chief, SPS, to the GS 6, medical technicians. The skill-level diversity of staff creates a supervisory challenge in maintaining staff expertise in a discipline of ever-changing technology. The incumbent must continually assure that SPS staff maintains quality and standards in reusable medical equipment (RME) processing.
• The incumbent provides oversight to all facility RME; assuring actions regarding facility RME purchases are appropriate.
• The incumbent provides oversight to all facility RME standard operating procedures (SOPs) to assure accordance with all procedures.
• The incumbent faces frequent deadline changes. Whenever the surgery schedule is altered, there is increased pressure for the Chief, SPS, to assure delivery of the alternate procedure trays. Interaction with the vendor/contractor to expedite delivery of required surgical items has a direct impact on the timeliness of surgery and patient care.
• The Chief, SPS, is responsible for assessing, monitoring, developing, and assisting with implementing corrective action plans for instrument and RME processing, decontamination, sterilization, biological monitoring, and high-level disinfecting monitoring.
• He/she will coordinate recall of facility sterilized items whose sterility may have been compromised.
• The Chief, SPS, is an active member of the Commodities Standards Committee, Medical Equipment Committee, and the Co-Chairperson of the RME Committee, and he/she will be an active participant in Environmental Rounds and Operating Room (OR)/SPS Quality Management (QM) meetings.
• The Chief, SPS, will collaborate and communicate information or concerns between clinical services and SPS.
• The Chief, SPS, manages the overall SPS budget including determining resource needs, allocating resources, and ensuring proper utilization in productivity, efficiency, and cost effectiveness of SPS operations.
• The Chief, SPS, is accountable to the Associate Director, Patient Care Services (AD-PCS)/Nurse Executive and networks closely with Inventory Management and Infection Control. He/she must be able to work independently with little direct supervision.
• Incumbent keeps the AD-PCS briefed on the status of different events, activities, and projects both within and external to the medical center. The incumbent exercises delegated authority to oversee the overall planning, direction, and timely execution of programs within SPS.

The Assistant Chief of Health Administration Service (HAS) serves fully in delegated authority of the HAS Chief; attends meetings as assigned and acts for the HAS Chief at such meetings. In the absence of the HAS Chief, the incumbent acts with full authority to manage and makes decisions pertinent to the entire HAS. The incumbent serves as the Assistant Chief, HAS. In this role, provides full assistance in the administrative and technical responsibility for the planning, organizing, directing, and managing wide variety of technical, administrative, management functions and processes for the HAS. This broad and diverse management program includes which includes AOD's, Advanced Medical Support Assistants, Health Information Management, Patient Registration, and Veterans Transportation Service.

Major duties include, but is not limited to:

• Supports the Chief HAS in developing a comprehensive health information management quality management program that assures the quality and accuracy of health information and assures compliance with official standards.
• Sets priorities and scheduling of regular Health Administrative Program audits.
• Analyzes inter-related issues of effectiveness, efficiency, and productivity of substantive mission-oriented programs within the HAS.
• Provides assistance to the Chief HAS in developing both long and short-range policies and plans for the organization by coordinating the medical administration needs of the medical center.
• Assists in the development of HAS goals, and objectives for the long-range implementation and administration of the HAS programs and develops criteria and performance measures for evaluating the effectiveness of the HAS.
• Responsible for assisting the HAS Chief in developing, implementing, and monitoring LVAMC programs that manage the use of medical services so that Veterans receive appropriate care in a cost-effective manner in an appropriate setting.
• Responsible for developing activities designed to maintain or improve the quality of service and healthcare delivered, meet budget projections for medical services, achieve Veteran satisfaction and respond to regulatory requirements.
• Prioritizes work assignments, manages workflow, and determines methods and procedures used by section personnel.
• Applies laws relating to the determination of eligibility for hospitalization and related services and benefits, including financial assessments as required.
• Provides for the processing of admissions, discharges, outpatient visits, patient transfers, billing, collection, beneficiary travel, death details, benefits and other miscellaneous services.
• Develops guidelines for data compatibility, consistency, and monitoring for compliance to improve the quality of clinical, financial and administrative data.
• Performs the administrative and human resource management functions relative to the staff supervised.
• Provides guidance and oversight of established guidelines and performance expectations for staff members, which are clearly communicated through the formal employee performance management system and executive career field performance management system.
• Observes manager's performance and conducts program performance critiques, periodically evaluates employee work performance.
• Provides advice and counsel to workers related to work and administrative matters and effects disciplinary measures as appropriate to the authority delegated in this area.
• Reviews and approves/disapproves leave requests and assures that subordinates are trained and fully comply with the provisions of the facility safety regulations.
• Resolves informal and formal complaints and grievances recommending personnel actions as necessary.
• Deals effectively with employees and union representatives on employee suggestions, complaints, grievances, and other matters in the daily administration of labor-management agreements.
• Performs other duties as assigned.

VA Careers - Social Work: https://youtube.com/embed/enRhz_ua_UU

The Service Chief is responsible for designing the mission and vision of the Service, developing the scope of practice and/or privileging packets for all social workers, designing a Social Work service Plan of Care and assuring implementation of quality improvement measures. Incumbent is responsible for developing, planning, clarifying, administering and managing Social Work Services for all areas of the Medical Center. Incumbent will designate service priorities and objectives, ensures the supervision and evaluation of all social work staff and is responsible for supervising and evaluating the performance of the social work supervisors. The Service Chief serves as a liaison to other Services or care-lines, other facilities, VISN offices and VHA Central Office.

Major duties include, but may not be limited to:

• Ensures provision of social work services and /or case management services in a variety of inpatient and outpatient program areas and clinics.
• Collaborates with others in negotiating deciding upon and/or coordinating social work related changes affecting other programs.
• Ensures Social Work Service will participate in the planning, implementation of treatment programs within area of practice.
• Reviews information pertaining to the social work program from a variety of sources and identifies requirements which must be expressed in medical in medical facility written policies and procedures, draft such statements or assigns tasks to subordinates to insure their completion.
• Performs or assigns responsibility and reviews, the results of Social Work Service internal evaluations for program effectiveness..
• Responsible for employee selection, promotions, work planning and organizing, compliant/grievance resolution, dealing with administration of labor management agreements and processing other managerial duties directly or through appropriate delegations.
• Responsible for determining appropriate level of staff qualifications and expertise necessary to assure accomplishment of Social Work Service Programs.
• Exercise both administrative and professional accountability and responsibility for all social workers who are in the Social Work GS-0185 series.
• Determines personnel, equipment, space, supply needs upon program goals.
• Provides direct patient care services
• Performs other duties as directed.

Coatesville VA Medical Center is a 42-building campus-style facility which sits on 128 acres and celebrated its 90th anniversary in November 2020. There are 301 inpatient and residential operating beds, and the medical center serves as a VA specialty referral facility for inpatient and residential mental health programs. In terms of inpatient beds, there are medical, psychiatry, and community living center (24-hour nursing care). Additional information can be found on our internet site VA Coatesville Health Care | Veterans Affairs.

• The Director of Quality Improvement is responsible for coordination and leadership in all performance and quality activities (Performance Measurement/Improvement, External Reviews/Accreditation, Risk Management/Peer Review Coordination, Infection Prevention, Patient Safety, Controlled Substance Program).
• This position is dedicated to the pursuit of higher facility-wide performance in each domain of value (quality, satisfaction, efficiency) through application of expertise, influence, management, and leadership.
• Ensures the facility overall performance and quality programs are coherent and consistent with the network and system wide goals and strategic objectives.
• Aligns and integrates a quality performance management system with leadership roles, strategic planning, and organizational culture. Establishes and maintains a quality measurement system which assesses clinical processes and outcomes, and identifies critical incidents, and the risk thereof, and sentinel events for actions.
• Creates a culture and environment that utilizes evidence-based practice as the pathway to improved outcomes and engages leaders and staff in the application of Just Culture principles.
• Supports and actively participates in initiatives such as Systems Redesign/Lean, Patient Centered Care, ICARE, and Cultural Transformation.
• Supports and participates in the engagement and change management of becoming a High Reliability Organization.

Major duties include but are not limited to:

• The Chief of Vascular is the clinical expert for all vascular services. The incumbent will supervise the surgeons, and APP's along with the Diagnostic Radiology Technicians who report to Surgery.
• Establishes effective operational policies, procedures, methods and work schedules to maintain access to timely care consistent with VHA goals.
• Directs the planning and coordination of vascular clinics across the facility and works with other Service Lines of the Medical Center and CBOC's to ensure that the veterans total needs are met and that the standard of clinical care provided meets or exceeds community standards.
• Develops business plans and workload analysis to support staffing models for additional resources and expansion.
• Works with other attending section chiefs, attending practitioners, NP's, PA's, nurses, residents, medical students' and members of various teams including Podiatry, Primary Care and Orthopedics to facilitate a comprehensive and interdisciplinary team approach, reflecting the highest level of patient care: Interprets and maintains standards published by the Department of Veterans Affairs and the Joint Commission.
• Evaluates the quality of appropriateness of care as an integral part of the overall Medical Center quality management program. This includes participation in medical center meetings, VISN meetings and national meetings that directly involve the Vascular Section.
• Supervising practitioner for students and residents who rotate through the Vascular Service line. Clinical duties include but are not limited to Operating Room (experience in a wide variety of podiatric surgical procedures), in-patient rounds, Emergency Room, and Inpatient/ Outpatient clinical visits.
• Participate in surgical quality/performance improvement initiatives as appropriate.
• Manage all aspects of clinic, emergency room, CLC, and inpatient wards. Coordinates assessment of veteran complaints and service recovery efforts as well as coordination of Medical Advisory Opinions as needed.
• Dually appointed with CMC VAMC and the Hospital University of Pennsylvania. Incumbent has oversight responsibility for the medical school students and residents within vascular services.
• Oversees Vascular specific time utilization to include appropriate prioritization of cases among all practitioners in Vascular, manage prospective waiting times for procedures, and assures completion of all practitioner documentation.
• Responsible for all FPPE/OPPE reviews internally and externally, along with completing all performance reviews for staff within the section. Incumbent collaborates in a joint effort with the Hospital of the University of Pennsylvania on selecting surgical candidates for CMC VAMC.
• Responsible for managing the full spectrum of surgical care responsibilities including admission from an outpatient site, evaluation, diagnosis and treatment, consultation for patients presenting with vascular surgery issues and diseases and the performance of invasive and surgical procedures. To manage the surgical care of patients the following will be necessary: ordering appropriate lab work, ordering appropriate diagnostic tests, requesting consultations to specialty services, providing both office-based and operating room based invasive procedures.
• All work activities, both administrative in nature and clinical, will be in conformance with VA, Joint Commission, and other standards as applicable that guide that provider's practice.
• The physician will work in a team setting with other physicians, nurse practitioners, registered nurses, and support staff assigned to perform duties to accomplish the treatment of veteran patients.
• Computer skills are essential as the Corporal Michael J. Crescenz VA Medical Center is fully computerized for note documentation, entering orders and requesting consults.

CLINICAL SCOPE OF DUTIES:

The Chief, Dental Service shall be knowledgeable of all disciplines of clinical dentistry as listed below. The Chief should also possess the expertise
and competency to perform their specific scope of practice defined through the medical center credentialing and privileging process.

• General Dentistry is the practice of prevention, diagnosis, and treatment of diseases, injuries, and malformation of the teeth, jaws, and human oral cavity and its adjacent tissues and structures.
• Oral Surgery is the dental discipline that deals with the diagnosis and treatment of oral conditions requiring surgical interventions including uncomplicated removal of teeth, recontouring of the alveolus, and other routine hard and soft tissue oral surgical procedures.
• Prosthodontics is the dental discipline of making artificial replacements for missing parts of the mouth and jaw.
• Periodontics is the dental discipline that deals with diseases of the supporting and investing structures of the teeth including the gums, cementum, periodontal membranes and alveolar bone.
• Endodontics is the dental discipline concerned with diseases of the pulp.

• Is knowledgeable of, and maintains Service compliance with a) VHA Handbooks and Directives, b) VISN Policies, c) Medical Center Memorandum and d) Service Policies and Procedures pertinent to dental clinic management.
• Is knowledgeable of regulatory requirements for VA dental residencies with an emphasis upon Resident Supervision.
• Is knowledgeable and capable for responding to Congressional inquiries regarding issues germane to the Dental Service.
• Is knowledgeable and in compliance with accreditation standards, including IG, Joint Commission, and other applicable survey/oversight entities.
• Is knowledgeable and in compliance with Safety and Environment of Care (EOC) standards and programs including the following:
  • MSDS Requirements.
  • The Joint Commission EOC Standards.
  • Disposal of Hazardous Wastes.
  • GEMS Program.
  • Facility Emergency Preparedness Plan.
  • Infection Control Guidelines for Dentistry including management of RME.
• Has a working understanding and knowledge of available reports and data sources available through VistA, VCCS, DSS and other VHA data sources to facilitate management of the Dental Service.
• Responsible for the fiscal oversight of the Dental Service:
  • Prepares and annual gap analysis to assess demand versus capacity.
  • Projects Dental Service workforce levels to meet current and future dental demand.
  • Assesses equipment and space needs for the Dental Service.
  • Prepares the Service annual budget and management briefing incorporating the gap analysis, workforce projections including contracts if applicable and equipment/space needs.
  • Collaborates with DSS to ensure appropriate labor mapping of all Dental Service staff.
  • Manages overtime in compliance with facility policy.
  • Manages the Dental Fee Base Program in compliance with applicable VHA
    and local policies.
  • Has knowledge of and utilizes system redesign principles to promote organization improvement, optimize overall Service efficiency and effectiveness.
• Develops performance metrics for all provider classification to drive performance and to direct desired behavior.
• Follows VHA Scheduling Directives to enhance the management of access.
• Is actively engaged in facility Quality Improvement activities, including compliance with the VA credentialing/privileging process and ensuring that an active Peer Review process is in place for Dental Service providers.
• Actively engaged in Service Recovering and have knowledge of SHEP and other patient satisfaction data sources. Uses customer service data for service improvement.
• Operates a sound personnel performance management system in compliance with the Union Master Agreement and HR policies including VHA labor relations policies.
• Responsible for, have knowledge of and/or ensuring that the following are current: Title 38, Hybrid Title 38, and Title 5 Position Descriptions or Functional Statements.
• Applicable competency documents for all applicable dental staff classifications.
• Performance Appraisal System including performance plans, performance target goals, rating system and awards program.
• Time and leave policy for all staff types.
• Grievance and arbitration procedures.
• Disciplinary action process.
• AIB and other investigative options.
• Has knowledge of and follows conflict of interest and ethics policies related to business practices/associations including contracting and procurement regulations.

VA Careers - Physical Therapy: https://youtube.com/embed/Gi2hoFqIoqY

Major Duties:

• Provides for the overall management of the Service. This includes interpreting administrative and clinical policies, developing and implementing local policies, defining administrative and clinical requirements, and providing advice to Medical Center leadership on related issues. Performs as the expert on administrative and clinical policies and requirements for the Service.
• Evaluates and monitors administrative and clinical activities and acts independently or makes substantive recommendations to the Executive Leadership Team to make Service improvements. Provides expert advice and technical assistance to Medical Center managers at all levels and supervisors and team leaders within the Service
  in a wide variety of areas, clinical and administrative, related to the Service.
• Directs the personnel management program for PM&R Service, performing or overseeing the full range of human resources requirements. Acts as personnel management expert for the Service Line. Functions as a Service leader with overall project responsibility as the primary Service representative for the Medical Center to redistribute the workforce, positions, and sections of the Service to comply with legislative or regulatory changes impacting the mission and goals of the Medical Center, VISN 4, National PM&R Program Office and VHA.
• Arranges for and participates in annual goal-setting/strategic planning sessions, coordinates the development of the final operating plan, and conducts continuing evaluations at the Service level as well as the Medical Center, VISN, and national levels as it relates to the activities of the Service addressing patient care delivery systems, facilities management, system reorganizations or other issues and initiatives
• Provides for the budgeting and financial management for the Service. Performs as an expert in budgeting and financial management for the Service and for the Medical Center as it relates to Service programs.
• Manages procurement and contracting for the Service Line and the Medical Center in projects related to the Service Line. Determines when contract termination is warranted and initiates action as appropriate with the accountable Contracting Officer.
• Serves as the official PM&R Service consultant to all other Medical Center
  services/departments and provides expert advice and technical assistance to entities outside the Medical Center including those within VISN 4 and at the national level on matters related to PM&R in the various roles in which the incumbent serves.
• Communicates effectively verbally and in written correspondence with employees and customers at all levels of the Service and Medical Center; Medical Center peers and superiors; individuals at the VISN, National PM&R Program Office as well as other Central Office level contacts; and stakeholders.
• Serves as first or second line supervisor to individuals in the Service to include, but not limited to, physicians, other providers, nurses, therapists, therapy assistants, therapy aides, administrative officer, medical support assistants and other Service staff.
• Oversees the work of Service employees and ensures the accuracy of reports submitted by supervisors and team leaders. Identifies and implements opportunities for improvement and ensures Service compliance with clinical and other standards based upon professional journal/literature reviews, Medical Center policies, VHA Directives, Clinical Practice Guidelines and other applicable documents.
• Assists Service supervisors and team leaders in implementing actions designed to improve administrative and clinical operations or resources.
• Has advanced knowledge in rehabilitative sciences, services, and care provision and the ability to translate this knowledge across disciplines supervised as well as into useful policy.
• Has advanced knowledge in evidence-based practices and clinical practice guidelines in all clinical areas supervised and the ability to use these resources to guide staff in providing clinically appropriate treatment interventions.
• Ensures each of the special program clinics, Polytrauma/Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) comply with Medical Center, VISN 4, National PM&R Program Office and VHA mission, goals, directives, practice guidelines and associated requirements.
• Ensures the Medical Center meets other performance measures directly affected by the Service including those related to traumatic brain injury, spinal cord injury and other programs which affect both the Medical Center and the VISN.
• Selects and recommends members of professional qualifications standards boards for therapy positions to the Medical Center Director and oversees the actions of applicable boards and determines when boards are convened for action.
• Resolves individual and group employee and customer grievances and conflicts at all levels of the Service and Medical Center.

Major Duties:

• Provides for the overall management of the Service. This includes interpreting administrative and clinical policies, developing and implementing local policies, defining administrative and clinical requirements, and providing advice to Medical Center leadership on related issues. Performs as the expert on administrative and clinical policies and requirements for the Service.
• Evaluates and monitors administrative and clinical activities and acts independently or makes substantive recommendations to the Executive Leadership Team to make Service improvements. Provides expert advice and technical assistance to Medical Center managers at all levels and supervisors and team leaders within the Service
  in a wide variety of areas, clinical and administrative, related to the Service.
• Directs the personnel management program for PM&R Service, performing or overseeing the full range of human resources requirements. Acts as personnel management expert for the Service Line. Functions as a Service leader with overall project responsibility as the primary Service representative for the Medical Center to redistribute the workforce, positions, and sections of the Service to comply with legislative or regulatory changes impacting the mission and goals of the Medical Center, VISN 4, National PM&R Program Office and VHA.
• Arranges for and participates in annual goal-setting/strategic planning sessions, coordinates the development of the final operating plan, and conducts continuing evaluations at the Service level as well as the Medical Center, VISN, and national levels as it relates to the activities of the Service addressing patient care delivery systems, facilities management, system reorganizations or other issues and initiatives
• Provides for the budgeting and financial management for the Service. Performs as an expert in budgeting and financial management for the Service and for the Medical Center as it relates to Service programs.
• Manages procurement and contracting for the Service Line and the Medical Center in projects related to the Service Line. Determines when contract termination is warranted and initiates action as appropriate with the accountable Contracting Officer.
• Serves as the official PM&R Service consultant to all other Medical Center
  services/departments and provides expert advice and technical assistance to entities outside the Medical Center including those within VISN 4 and at the national level on matters related to PM&R in the various roles in which the incumbent serves.
• Communicates effectively verbally and in written correspondence with employees and customers at all levels of the Service and Medical Center; Medical Center peers and superiors; individuals at the VISN, National PM&R Program Office as well as other Central Office level contacts; and stakeholders.
• Serves as first or second line supervisor to individuals in the Service to include, but not limited to, physicians, other providers, nurses, therapists, therapy assistants, therapy aides, administrative officer, medical support assistants and other Service staff.
• Oversees the work of Service employees and ensures the accuracy of reports submitted by supervisors and team leaders. Identifies and implements opportunities for improvement and ensures Service compliance with clinical and other standards based upon professional journal/literature reviews, Medical Center policies, VHA Directives, Clinical Practice Guidelines and other applicable documents.
• Assists Service supervisors and team leaders in implementing actions designed to improve administrative and clinical operations or resources.
• Has advanced knowledge in rehabilitative sciences, services, and care provision and the ability to translate this knowledge across disciplines supervised as well as into useful policy.
• Has advanced knowledge in evidence-based practices and clinical practice guidelines in all clinical areas supervised and the ability to use these resources to guide staff in providing clinically appropriate treatment interventions.
• Ensures each of the special program clinics, Polytrauma/Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) comply with Medical Center, VISN 4, National PM&R Program Office and VHA mission, goals, directives, practice guidelines and associated requirements.
• Ensures the Medical Center meets other performance measures directly affected by the Service including those related to traumatic brain injury, spinal cord injury and other programs which affect both the Medical Center and the VISN.
• Selects and recommends members of professional qualifications standards boards for therapy positions to the Medical Center Director and oversees the actions of applicable boards and determines when boards are convened for action.
• Resolves individual and group employee and customer grievances and conflicts at all levels of the Service and Medical Center.

Major Duties:

• Provides for the overall management of the Service. This includes interpreting administrative and clinical policies, developing and implementing local policies, defining administrative and clinical requirements, and providing advice to Medical Center leadership on related issues. Performs as the expert on administrative and clinical policies and requirements for the Service.
• Evaluates and monitors administrative and clinical activities and acts independently or makes substantive recommendations to the Executive Leadership Team to make Service improvements. Provides expert advice and technical assistance to Medical Center managers at all levels and supervisors and team leaders within the Service
  in a wide variety of areas, clinical and administrative, related to the Service.
• Directs the personnel management program for PM&R Service, performing or overseeing the full range of human resources requirements. Acts as personnel management expert for the Service Line. Functions as a Service leader with overall project responsibility as the primary Service representative for the Medical Center to redistribute the workforce, positions, and sections of the Service to comply with legislative or regulatory changes impacting the mission and goals of the Medical Center, VISN 4, National PM&R Program Office and VHA.
• Arranges for and participates in annual goal-setting/strategic planning sessions, coordinates the development of the final operating plan, and conducts continuing evaluations at the Service level as well as the Medical Center, VISN, and national levels as it relates to the activities of the Service addressing patient care delivery systems, facilities management, system reorganizations or other issues and initiatives
• Provides for the budgeting and financial management for the Service. Performs as an expert in budgeting and financial management for the Service and for the Medical Center as it relates to Service programs.
• Manages procurement and contracting for the Service Line and the Medical Center in projects related to the Service Line. Determines when contract termination is warranted and initiates action as appropriate with the accountable Contracting Officer.
• Serves as the official PM&R Service consultant to all other Medical Center
  services/departments and provides expert advice and technical assistance to entities outside the Medical Center including those within VISN 4 and at the national level on matters related to PM&R in the various roles in which the incumbent serves.
• Communicates effectively verbally and in written correspondence with employees and customers at all levels of the Service and Medical Center; Medical Center peers and superiors; individuals at the VISN, National PM&R Program Office as well as other Central Office level contacts; and stakeholders.
• Serves as first or second line supervisor to individuals in the Service to include, but not limited to, physicians, other providers, nurses, therapists, therapy assistants, therapy aides, administrative officer, medical support assistants and other Service staff.
• Oversees the work of Service employees and ensures the accuracy of reports submitted by supervisors and team leaders. Identifies and implements opportunities for improvement and ensures Service compliance with clinical and other standards based upon professional journal/literature reviews, Medical Center policies, VHA Directives, Clinical Practice Guidelines and other applicable documents.
• Assists Service supervisors and team leaders in implementing actions designed to improve administrative and clinical operations or resources.
• Has advanced knowledge in rehabilitative sciences, services, and care provision and the ability to translate this knowledge across disciplines supervised as well as into useful policy.
• Has advanced knowledge in evidence-based practices and clinical practice guidelines in all clinical areas supervised and the ability to use these resources to guide staff in providing clinically appropriate treatment interventions.
• Ensures each of the special program clinics, Polytrauma/Traumatic Brain Injury (TBI) and Spinal Cord Injury (SCI) comply with Medical Center, VISN 4, National PM&R Program Office and VHA mission, goals, directives, practice guidelines and associated requirements.
• Ensures the Medical Center meets other performance measures directly affected by the Service including those related to traumatic brain injury, spinal cord injury and other programs which affect both the Medical Center and the VISN.
• Selects and recommends members of professional qualifications standards boards for therapy positions to the Medical Center Director and oversees the actions of applicable boards and determines when boards are convened for action.
• Resolves individual and group employee and customer grievances and conflicts at all levels of the Service and Medical Center.

Coatesville VA Medical Center is a 42-building campus-style facility which sits on 128 acres and celebrated its 90th anniversary in November 2020. There are 301 inpatient and residential operating beds, and the medical center serves as a VA specialty referral facility for inpatient and residential mental health programs. In terms of inpatient beds, there are medical, psychiatry, and community living center (24-hour nursing care). Additional information can be found on our internet site VA Coatesville Health Care | Veterans Affairs.

• The Director of Quality Improvement is responsible for coordination and leadership in all performance and quality activities (Performance Measurement/Improvement, External Reviews/Accreditation, Risk Management/Peer Review Coordination, Infection Prevention, Patient Safety, Controlled Substance Program).
• This position is dedicated to the pursuit of higher facility-wide performance in each domain of value (quality, satisfaction, efficiency) through application of expertise, influence, management, and leadership.
• Ensures the facility overall performance and quality programs are coherent and consistent with the network and system wide goals and strategic objectives.
• Aligns and integrates a quality performance management system with leadership roles, strategic planning, and organizational culture. Establishes and maintains a quality measurement system which assesses clinical processes and outcomes, and identifies critical incidents, and the risk thereof, and sentinel events for actions.
• Creates a culture and environment that utilizes evidence-based practice as the pathway to improved outcomes and engages leaders and staff in the application of Just Culture principles.
• Supports and actively participates in initiatives such as Systems Redesign/Lean, Patient Centered Care, ICARE, and Cultural Transformation.
• Supports and participates in the engagement and change management of becoming a High Reliability Organization.

Company :

Job Description : 

JOB SUMMARY

This job, as part of a  physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards.  The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service.  Depending on the nature of the case, telephonic peer to peer discussions may be required.  The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times.  In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management.  They will advise the multidisciplinary team on cases, particularly high risk cases, through the team structure.  Additionally, the incumbent may be assigned special projects to help support and improve the care of our members.  

ESSENTIAL RESPONSIBILITIES

• Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness.  Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned.  Compose clear and concises rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.).  Ensure that all aspects of the medical management process are consistent with community standards of care.
• Participate as a member of the CMDM multidisciplinary team.  Attend huddles and grand rounds.  Advise multidisciplinary team on cases that require physician expertise. 
• Participate in protocol and guidelines development to ensure consistency in the review process. 
• Actively manage projects and/or participate on project teams that require a physician subject matter expert.
• Other duties as assigned.

EDUCATION

Required

• Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)

Substitutions

• None

Preferred

• Master's Degree in Business Administration/Management or Public Health

EXPERIENCE

Required

• 5 - 7 years in Clinical, Direct Patient care (hospital, outpatient, or private practice)
• 1 - 3 years in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry

Preferred

• None

LICENSES AND CERTIFICATION

Required

• Medical Doctor or Doctor of Osteopathic Medicine (DO), with an active, unrestricted license to practice in any U.S. state
• Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards

Preferred

• None

SKILLS

• Critical Thinking
• Case Management
• Customer Service
• Oral & Written Communication Skills
• Collaboration
• Listening
• Telephone Skills
• General Computer Skills
• Clinical Software
• Managed Care

Language (Other than English)

None 

Travel Required

0%  - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required 

No

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf)

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