Clinical Operations Specialist I

FLSA Classification: Exempt
Department: Clinical Operations Specialists
Reports To: Clinical Operations Manager
Direct Reports: N/A

POSITION SUMMARY:
The Clinical Operations Specialist II (COS II) is responsible for managing all clinical operations reporting related to timely documentation and compliance. The COS II also presents clinical operations statistics reporting to management, identifies trends and areas of improvement, and presents and executes solutions to enhance operations.

RESPONSIBILITIES:
• Manages, investigates, and resolves all necessary clinical operations reporting, including but not limited to:
◦ Missed & Eliminated Visits
◦ Late Documentation
◦ Visit Reasons
◦ Authorizations
◦ ABN’s (Advanced Beneficiary Notice)
◦ On-Call Report
◦ Patients without orders
• Prints, sorts, and tracks compliance of patient friendly care plans.
• Monitors patient ping and sends communication to CD/CCM/Nurse
• Monitors EFAX and communicates with appropriate departments.
• Managers tracking tools as directed by CD/CCM.
• Monitors Homebound patient status documentation.
• Develops, presents, and executes solutions to management that will enhance areas of improvement and act on trends that may impact business operations.
• Monitors and follows up on nurses’ expiring credentials.
• Managers inventory of office supplies and medical supplies
• Scans and verifies paper visit notes as needed.
• Greets all incoming visitors and arranges interviews and meeting as necessary.
• Maintains a clean, presentable, and functioning office space.
• Answers all incoming calls in a professional manner and triage to the appropriate person or department.
• Provides operational support to Assistant Clinical Director, Operations Director, and other employees as needed.
• Reads and adheres to and participates in the Branch's mandatory HIPAA/Privacy Program and Employee Compliance Program.
• Reads and adheres to all Branch policies and procedures and follows Employee Handbook guidelines.
• Performs other duties as assigned.

COMPETENCIES:
• Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.


• Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem solving situations; Uses reason even when dealing with emotional topics.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments.
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives.

REQUIRED QUALIFICATIONS:
• Bachelor’s degree (or equivalent in work experience) in business or healthcare related field
• 5+ years’ relevant business, operations, or healthcare experience
• Advanced proficiency in Windows environment, with emphasis on Excel, Outlook, and Word
• Proven track record of successfully defining, managing, and optimizing operational workflows
• Experience with escalation management

PREFERRED EDUCATION AND EXPERIENCE:
• 2+ years’ experience in home health environment
• Knowledge of OASIS, CMS, and MassHealth guidelines

PHYSICAL DEMANDS AND OFFICE ENVIRONMENT:
• Occasionally required to stand.
• Occasionally required to walk.
• Frequently required to sit.
• Continually required to use hands and fingers.
• Occasionally required climb, balance, bend, stoop, kneel or crawl.
• Occasionally required to lift/push light weights (less than 25 pounds).

TRAVEL REQUIREMENTS:
• Ability to travel locally by car to office(s), events, meetings, etc., as needed (approximately __30__% of the time).


Innovive Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or