Innovacare Health, Inc. is a leading provider of managed healthcare services in North America. Through two primary avenues of care, Provider Networks and Medicare Advantage, they are committed to quality healthcare by creating models that are cost-effective and fully integrated with advanced technologies.
The company is a leading Medicare Advantage organization providing healthcare-related services in Puerto Rico since 2001 and most recently entering South and Central Florida.
This organization operates a medical service organization, which coordinates care through a network of more than 27 independent physician associations, over 4,2000 primary care physicians and 26 clinics.
Additionally, it operates two Medicare Advantage plans, the Islandâs only NCQA-accredited health plans, which serve 200,000 members on the Island with a network of more than 7,500 providers.The President of Clinics oversees and provides strategic direction, planning, and leadership for clinic operations in Puerto Rico. Implements initiatives to develop and enhance assigned service lines. Participates in the formulation of initiatives to address the developing needs of the community, changing trends in healthcare, and advance the organization’s mission, goals, and vision. Provides guidance to ensure that assigned division provides the highest quality, most cost effective healthcare possible, and that operations are in compliance with the NCQA guidelines as well as federal, state, and local laws and regulations.
Innovacare Health is seeking a President of Clinics in our Puerto Rico market.
The President of Clinics manages, develops, and oversees daily physician clinic operations including achieving operating and capital budgets, coding for maximum reimbursement, appropriate billing practices, engages in community and local employer wellness programming and service delivery to stakeholders.
Essential Duties and Responsibilities
The President of clinic services plans, directs and evaluates the administrative and operational functions of clinic services at MMM Healthcare and all off site clinic locations.
The scope may also include working with the Federally Qualified Health Center (FQHC) clinic operations and sites.
The President is accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our patients, and to purchasers, contracted providers and vendors.
This position consistently supports compliance and the code of conduct by maintaining confidentiality, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable Federal and State laws and regulations, accreditation and licensure requirements.
The President will have direct accountability for managing resources through proper budgeting, planning, utilization, evaluation and corrective action in accordance with established policies, procedures and practices for the clinics.
Develops and implements short and long-range goals and is responsible for measurable outcomes and effective use of resources. Responsible for program and service development in response to both internal and external stakeholders.
Establishes working relationships with area employers and key stakeholders.
Develops and meets capital and operating budget targets. Utilizes data driven practice management skills to seek out operational efficiencies and involves employees and physicians in workforce redesign as appropriate to better serve the patient as well as create a workplace that employees can function at their highest competency and productivity. Teaches and engages employees in department financial improvement and performance.
Recruits, develops, retains and leads a talented team of management and staff committed to accomplishing the goals of Clinics. Oversees all human resource activities including recruitment, retention, performance reviews, and disciplinary actions. Develops, revises and implements administrative policies, procedures, guidelines and job descriptions. Acts as a mentor and promotes professional growth of employees. Takes responsibility for personal growth and development and meets all system education requirements.
Builds consensus with the Medical Staff, working in cooperation with physicians on related strategy and program initiatives
Practices process improvement principles and oversee improvement of quality of the services and patient care provided. Maintains competency in all organizational, department standards relevant to services provided and ensures compliance. Manages processes to ensure all regulatory standards are met as well as works to prevent potential legal risk to Clinics as appropriate. Accesses internal resources to assist in adhering to standards as well as ensures staff understands expectations.
Forecast and develop annual budgets; develops plan to control expenses, achieve budgeted goals and maximize profits.
Represents clinic and interacts with regulatory agencies, insurance carriers, and other professional and community groups.
Maintains compliance with and keeps Directors abreast of governmental regulations and industry requirements.
Enhances operational effectiveness, emphasizing cost containment and high quality patient care.
Resolves operational problems and keeps lines of communication open with staff to ensure high productivity. Conducts regular management meetings to discuss goals, accomplishments and strategies.
Maintains professional affiliations and enhances professional development to keep current in the latest health care trends and developments.
In addition – Other Skills Needed
Extensive direct clinical operational skills
Understands day to day operations including staffing, P&L, scheduling
Has managed more than 3-5 clinics
Understands managed care
Experience in primary and specialty clinics
Education & Experience
4 years degree & 10 years related experience and/or training or experience/education
Certificates, Licenses and/or Registrations:
Master’s Degree in Healthcare Administration, Business Administration or equivalent. Significant experience (5-10 years) in management of a large ambulatory care setting or multi-specialty group practice, including management of human resources
Active American College of Healthcare Executives (FACHE Credentials preferred).
Additional Skills and Abilities:
Proven administrative skills including the ability to organize tasks and provide clear direction and leadership to others. Proven ability to work effectively with other health professional, including physicians and administrators
Understanding the legal and professional context in which ambulatory health care is provided
Understanding of principles of budgeting for health care services and the financial controls necessary to function in a cost-effective manner
Experience in all areas of strategic planning, financial planning, program development, quality improvement, and project management in the health care services setting
Knowledge of managed care contracting and capitation
Knowledge of issues and trends that will affect the future of physician practices and ambulatory care services
Excellent interpersonal skills
Strong negotiating skills
Knowledge of governmental regulations and industry requirements
Knowledge of ambulatory/pro-fee coding and physician audit functions
Proficient in MS Office Products: Word, Excel, Powerpoint
Excellent verbal and written communication skills
Able to build and maintain positive community relations
Knowledge of healthcare industry â Health Plan, MSO, CMS, Federal
Strong skills in strategic and quantitative analysis, project management, negotiation, communication and leadership are essential.
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