Senior Administrative Director - Ambulatory Obgyn

The Senior Administrative Director is an integral part of the departmental senior management team, directly responsible for administrative, operational, and fiscal oversight over the Department of Obstetrics and Gynecology's (OBGYN) ambulatory clinical operations and technical functions. Reporting to the Department Administrator, the Senior Administrative Director has operational responsibility for all practices that the department directly manages (currently 15 practices), coordination with practice sites where the Department's faculty also see patients (e.g. Foxborough, Westwood, Braintree, and NWH), and leads strategic planning for ambulatory divisions. Through relationships with key clinical partners, the Nursing Director, Department Administrator and physician directors, and oversight of the practice managers and technical leaders, provides strong clinical leadership to strategize and operationally implement clinical priorities. Drawing upon a broad understanding of hospital practices and policies, and displaying a high degree of initiative and independent judgment, the Senior Director will continually and proactively assess and direct a wide range of programmatic issues directly related to daily operations including personnel management, practice management, billing/finance, long-range planning, facilities/systems, and project/program development. S/he will work with all the physicians and practice management staff to ensure a quality-based, customer-oriented flow of work. This position is expected to develop and maintain effective working relationships at all levels to collaboratively and proactively carry out the goals, objectives, and initiatives of the Department of OBGYN and deal with issues that are significant, sensitive, political and confidential in nature.

Principal Duties and Responsibilities

1.Department Administration

• Provide leadership and oversight in all areas relating to practice front-end and clinical support operations across the Department's ambulatory practices (currently 15 practices) and technical teams (Genetic Counseling (11), High Risk Ultrasound (12), Embryology (11), and Financial Managed Care (16)).

• Continuously assess and improve the efficiency of systems and processes.

• Initiate changes in clinical operations to directly drive revenue enhancement, patient access and quality clinical care through collaboration with department leaders across functional groups.

• Independently leads MGB, BWH, OBGYN faculty and department driven initiatives in relation to ambulatory practices, employee and patient process/performance improvement.

• Independently leads Epic/EMR enhancements, including planning, communication, recommendations, updates, and support.

• In conjunction with Nursing and Physician leadership, develop and implement Clinical policies and procedures, consistent with the Department and Hospital's policies and ensures adherence with these policies.

• In coordination with the Department Administrator and/or Division Directors, review the ongoing management of the Departments' clinical services, discuss and resolve any administrative problems that arise and direct the planning of improvements in existing clinical services and the introduction of new services in the Department. Ensure that the Department possesses state of the art information on equipment currently in use and equipment that is available, and proactively manages capital needs and purchases. Coordinate with institutional partners to ensure equipment standards are met for all equipment. Proactively manage preventative maintenance and contracts.

• Collaborate with and provide support to offsite partners to ensure operations support clinical activities of Department faculty (e.g., Foxborough, Westwood, Braintree, NWH), including but not limited to workflow optimization/coordination, patient experience escalations, non-employee system access (ie POI management), and associated processes related to care delivery.

• Lead for triaging and ensuring patients from the BWH Connection and internal referrals are escalated in a timely manner.

2.Strategic Planning

• Leads efforts to identify and assess potential opportunities for ambulatory growth, including new practice locations or service offerings.

• Independently responsible for all aspects of practice startup for new location, including space planning, collaboration with local and institutional leadership as required, and collaboration with departmental clinical leaders and practice managers.

• Independently develops business plans and justifications during annual budget planning and as necessary throughout the year to justify and seek approval for new ambulatory initiatives, including new practice sites, programs, service offerings or capital investments to facilitate programmatic growth and meet departmental needs and goals. Develops implementation plans for newly approved initiatives / services, partnering with internal and external stakeholders as appropriate.

3.Financial Operations

• Independently oversee and manage the 9 ambulatory divisions annual hospital operating budgets which includes volume/revenue, new initiatives, capital/renovations, non-labor expense, and opportunities for savings in collaboration with ambulatory leadership and hospital finance.

• Proactively and independently track spending vs budget for all Ambulatory OBGYN cost centers, identify savings opportunities, and work with management team to resolve variances in spending. Report anticipated variances to hospital finance and Department Administrator and makes recommendations for resolution. Prepare detailed explanations for unfavorable budget performance and volume across practices.

• Independent, proactive management of budgeted FTEs via Position Control. Strategically managing Position Control off cycle requests and changes to the budget, seeking necessary DA/SVP approval as appropriate.

• PeopleSoft approver for all ambulatory cost centers which include all financial orders >$1k and all employee financial transactions (bonuses, salary changes, etc).

• Works closely with the hospital finance and coding, and revenue integrity on accurate visit leveling, reconciliation of charge code errors, and escalated patient bills. Oversees escalations with providers to ensure timely closure of encounters / notes in accordance with system-wide compliance standards.

• Department's main contact for all ambulatory budget and financial inquiries and escalations.

• Works with practice mangers and hospital billing teams to identify best practices and process to improve front end billing operations including office copay collections and referral and registration management.

• Works with the Managers to implement new policies and procedures as needed.

• Educate faculty and staff on clinical reimbursement issues as needed.

• Liaison with the Departments billing team as necessary. Works with the agent in determining and resolving billing opportunities and problems.

• Direct oversight of Managed Care Team to actively manage prior authorizations, medication authorizations, procedural authorizations, payor enrollment and other initiatives to reduce write offs and denials across the department.

4.Regulatory Compliance and Activities

• Coordinates quality improvement activities for the Department. Develops administrative quality controls to ensure that the clinical operations are performing at or exceeding expectations.

• Ensures compliance with regulatory and infection control standards and directs quality improvement activities at all sites. Make sure that the Practice's operations are compliant with other BWPO and BWH policies and procedures, as well as with all relevant regulatory requirements. Where compliance is inadequate, initiate corrective action promptly.

• Ensure compliance with all regulatory standards, included those promulgated by JCAHO, DPH, OSHA, CLIA, etc. Maintain a thorough understanding of all relevant regulatory matters. Lead ambulatory point of contact for Joint Commission full and lab survey and all other regulatory site visits in collaboration with physician leadership, nursing, and practice leadership teams.

• Maintains patient confidentiality according to hospital standards.

• Leads the faculty and clinical (RN & MA) teams' annual clinical competencies in a timely manner to the correct hospital stakeholders which include Provider Microscopy, Point of Care testing, high level disinfection, and Manikin/AED training etc. Partner with Nursing Administration as necessary for centrally managed RN competencies.

• Lead for all regulatory logs and HR files in the Ambulatory department and ensuring compliant.

5.Human Resources

• Direct supervisor for the ambulatory practice leadership and technical leads, including practice managers/administrators (5 FTEs), Genetic Counselor Manager (1 FTE), Chief Sonographer (1 FTE), Embryology Technical Director (1 FTE), and Managed Care Manager (1 FTE). Additionally, is a second line supervisor for ~150 clinical FTEs (Practice Assistants, Medical Assistants, Practice Supervisors, Surgical Schedulers, Embryology, Genetic Counselors, Sonographers, and Managed Care Coordinators, Financial Managed Cate teams).

• Manages all Human Resources and professionalism escalations for faculty, leadership team, clinic staff and technical teams. In coordination with the MD leadership and HR, discuss and resolve any administrative, financial, and interpersonal problems. Further escalates to the Department Chair and Administrator when pattern persists to follow hospital documentation policy.

• Functions as a mentor to direct reports and works with them in furthering their own growth and development by establishing clear goals and objectives for skill enhancement.

• Helps establish clear career plans and works to assist staff in achieving their goals.

• Work with and mentors managers to foster leadership, confidence and teambuilding. Develop job descriptions, prepares performance plans, conducts annual performance appraisals and establishes an ongoing feedback mechanism for staff.

• Establishes and communicates clear guidelines regarding both technical and behavioral expectations relevant to their positions.

• Responsible for handling numerous personnel matters, including reviewing and approving all ambulatory staff hiring, firing, compensation and evaluation decisions. Implement all institutional policies related to all phases of personnel activity, including recruitment, interviewing, compensation, benefits, orientation, performance evaluations, promotions, transfers, terminations. Transmit and interprets institutional policies to supervisors and employees. Ensure appropriate training of employees. May be asked to write job descriptions, enter into discussions with Human Resources to determine grades for new positions, annual rates of pay for new hires, increases for employees who are promoted, and equity increases. Assess employee workload and recommend changes as needed. Monitor hiring trends to ensure market competitiveness. Arbitrate disputes. Represent the Department in employee-relations matters.

• Oversee preparation of all personnel forms for the Clinical areas, including requisitions for new employees, change of status forms and termination reports. Notify supervisors of probationary and quarterly evaluation deadlines and ensure that the appropriate paperwork is completed.

• Develop OBGYN specific job performance aids and training sessions to support staff knowledge and development.

• Continually evaluate staffing levels and structure against volume of work and distribution of labor to improve support staff productivity and efficiency. Recommends necessary changes and creates business plans in conjunction with the Department Administrator. Independently implements approved staffing changes.

• Increase the role of support staff, giving them greater operational responsibilities that reinforce the core values of the Department and ensure that the clinical goals of the Department are reached and maintained.

• Upholds and adheres to Department processes and standards

• Develops job descriptions, prepares performance plans, conducts annual performance appraisals and establishes an ongoing feedback mechanism for staff. This specifically includes, but is not limited to:

• Timely completion of annual performance appraisals on or before merit due date

• Establish, document and demonstrate constructive feedback mechanisms based on employee needs, position and tenure

• Maintains accurate and up to date employee records, monitors performance, and time and attendance in accordance with hospital and departmental policies.
  6.Other Administrative Responsibilities

• As a key member of the department's clinical management team actively participates in hospital, ambulatory administration, finance, departmental senior leadership, all 9 divisions' leadership and all staff, direct reports 1:1, role group councils and Ambulatory all staff, and Medical Directors meetings.

• Demonstrates a thorough understanding to ensure the success of the partnership between the Department, the Hospital, the Brigham and Women's Hospital Physician Organization, and Mass General Brigham System through the development of systems of governance and the development of collaborative relationships.

• Involved in space needs planning for clinical services within the Department. Involved in overseeing the design of space renovations for Clinical facilities, identify and resolve facility problems that arise. Supervise facilities management of clinical space maintained by the Department.

• Supports the establishment of new practices, as necessary at the direction of the Department Administrator.

• Manage the diverse needs of the practices and physicians, include those related to facilities, information systems, communication, coordination among entities, marketing, managed care, etc.

• In conjunction with the Division Directors, develop and facilitate provider orientation and training as necessary.

• Establish and maintain a good working relationship with physicians to identify clinical and administrative needs and implement change.

• In collaboration with the Division Directors and Practice Managers identify, recommend and implement information systems needs for the practices.

• Perform other duties, as assigned or requested

• Bachelors degree required, Post Graduate degree in healthcare administration or related field strongly preferred

• 5-7 years of management experience in an academic healthcare environment, including a minimum of 3 years of supervisory experience preferred

• 3 years of ambulatory practice experience required, preferably in a supervisory or management role

• Minimum of two years progressively responsible financial management, required

• Experience managing diverse teams, strongly preferred

• Knowledge of business environments, sales and/or customer service experience