Health Insurance Operations Director jobs in Maine

Position Summary: 

Under the supervision of the System Vice President of Perioperative Services – Covenant and the Vice President of Patient Care Services – St. Mary's Healthcare, is responsible for the coordination of clinical services for the Operating Room and Sterile Processing Department.  Assures the mission, philosophy, goals, and policies of the organization and nursing department are implemented. In collaboration with the Vice President of Patient Care Services and others, when appropriate, plans, organizes, directs, and coordinates nursing services to meet licensing and accreditation requirements. 

Education/License:

• Bachelor's Degree in a related field.

Experience:

• More than 5 yrs as Director of an intermediate size surgical services division.

Position Competencies:

• Coordinates daily staffing patterns to insure appropriate skill mix, numbers and competency for a 24-hour day.
• Assesses the educational needs of staff and develops an education plan to address identified needs.  Participate in educational activities when appropriate.
• Interviews, hires, counsels, evaluates performance and/or discipline according to nursing and hospital policy.
• Accountable for efficient use of all resources: personnel, equipment, finances.
• Monitors quality of care through data review, observation, patient, physician and staff in-put.  Is accountable for outcome measurement and management.
• Work collaboratively with others to solve problems and to achieve desired outcomes.
• Dealing with high-risk variances and patient care issues.
• Participate in professional organizations as appropriate.  Maintains proficiency.
• Promotes and participates in community activities to facilitate public awareness of hospital and nursing services.
• Collaborates with all departments, internally and externally, as well as physician offices and other institutions, to promote an integrated healthcare delivery system.
• Serves on hospital and nursing committees as designated.
• Responsible for the day-to-day operations of the Sterile Processing Department, ensuring that all policies and procedures are followed, staff are proficient and patient safety and quality are maintained at all times.
• Exhibits flexibility and the ability to effect change in the changing healthcare environment.
• Meets regularly with a surgical services chief to directly market surgical services to physicians and achieve market share growth.
• Plans and effects capital equipment acquisitions over short and long range periods.  Monitors achievement of planned increases in utilization based on capital acquisition and marketing efforts.
• Maintains and provides statistical database to the Vice President of Patient Care Services which substantiates human resource allocation and operating time utilization and inpatient/outpatient numbers of surgeries/procedures in an agreed upon format. 
• Reviews, designs, and implements nursing policies and procedures to establish and maintain a safe environment for all surgical patients.
• Foster the establishment of subspecialty operating room teams and back up teams to effect delivery of varied services.
• Maintains the educational skill level of all staff in the most currently practiced and upcoming surgical/diagnostic services.
• Establishes a mechanism for meeting ongoing staff development.  All educational efforts must foster optimal attitudes and communication skills in all staff members.
• Assures compliance with state licensing, JCAHO, and regulatory (OSHA, etc.) agency rules and regulations for all assigned areas.
• Plans for future direction and improvement of the department to keep pace with the changes in medicine and technology.
• Manages difficulties which influence efficient operations of the area and other related areas.
• Prepares an annual budget in collaboration with the Vice President of Patient Care Services.  Responsible for operating within its limits and within hospital limits, flexing staff up and down as appropriate.  Review financial expenditures.  Authorizes purchase of supplies and equipment.
• Supervises all administrative functions of supervisors in assigned areas.  Determines personnel requirements for the department in collaboration with the supervisors.
• Resolves conflicts between personnel.
• Works collaboratively with the Vice President of patient Care Services and Quality Management to resolve unanticipated events in the best interest of patients, providers and the organization.
• If there is a need, we may function in the various staff roles within the departments to help cover.

Covenant Health Mission Statement

We are a Catholic health ministry, providing healing and care for the whole person, in service to all in our communities.

Our Core Values:

•Compassion

We show respect, caring and sensitivity towards all, honoring the dignity of each person, especially the poor, vulnerable and suffering.

•Integrity

We promote justice and ethical behavior, and responsibly steward our human, financial and environmental resources.

•Collaboration

We work in partnership, dialogue and shared purpose to create healthy communities.

•Excellence

We deliver all services at the highest level of quality, while seeking creative innovation.

Applicants, employees and former employees are protected from employment discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age (40 or older), disability, and genetic information (including family medical history).