Clinical Outcomes Program Manager

Job Description

The Clinical Outcomes Program Manager is a key healthcare professional responsible for developing, implementing, and managing a comprehensive clinical program within a healthcare facility or organization. This role plays a crucial part in improving patient outcomes, reducing mortality rates, and enhancing the overall quality of care.
 

Responsibilities

Accountable and responsible twenty-four hours per day for managing, guiding, developing, and implementing safe clinical practice and high-quality patient care. Works collaboratively with hospital administrators, physicians, nursing staff, and various other hospital staff members to improve clinical outcomes and processes of care for all patients at Our Lady of the Lake Health and throughout our network of care. Utilizes in-depth knowledge of the clinical/disease process to drive improvement through various roles and alliances. Accountable for the development of clinical-ready programs, personnel, and quality. Accountable for adherence to all regulatory and professional standards. Leads in promoting the mission of healing and nurturing in the program, through the organization, and in the community. Reports to the Sr. Director of Quality. 

20%
Develop and implement educational materials for patients and their families regarding condition/disease prevention, recognition, and post-discharge care.
Advocate for resources and policies that support optimal clinical care. By ensuring access to necessary equipment, medications, and personnel, they contribute to a smoother care experience for patients.
Develops protocols for post-discharge follow-up to monitor patients' recovery progress and address any lingering concerns or complications. This proactive approach can enhance continuity of care and patient satisfaction.
Work closely with healthcare teams to streamline and coordinate care processes for patients. This coordination ensures that patients receive timely and appropriate interventions, which can positively impact their overall experience.
Establish mechanisms for collecting feedback from patients and their families about their experiences. Use this feedback to identify areas for improvement and implement changes to enhance patient satisfaction and outcomes continuously.

20%
Develop and manage the budget for the clinical program, including allocation of funds for staff training, equipment procurement, educational materials, and quality improvement initiatives. Monitor expenditures and ensure that spending aligns with budgetary constraints and organizational goals.
Conduct cost-benefit analyses to evaluate the financial impact of disease/condition prevention and management strategies. Assess the cost-effectiveness of interventions such as early detection protocols, standardized treatment pathways, and quality improvement initiatives to justify resource allocation and identify opportunities for cost savings.
Stay informed about Medicare, Medicaid, and private insurance reimbursement policies related to care. Ensure that documentation practices comply with billing requirements to maximize reimbursement and prevent revenue loss due to denials or audits. Collaborate with coding and billing staff to accurately code condition/disease-related diagnoses and procedures for optimal reimbursement.
Identify resource gaps and inefficiencies in care delivery processes and recommend solutions to optimize resource utilization. Prioritize investments in resources that have the greatest impact on patient outcomes and cost-effectiveness, such as staff training, diagnostic technologies, and evidence-based treatments.
Seek external funding opportunities through grants, sponsorships, and partnerships to support condition/disease-related research, education, and quality improvement initiatives. Prepare grant proposals, budget justifications, and progress reports to secure funding from government agencies, philanthropic organizations, and industry partners. Collaborate with finance and development teams to ensure compliance with grant requirements and reporting deadlines.

20%
Design and implement a clinical program aligned with national guidelines, best practices, and regulatory requirements.
Work with clinical teams to integrate clinical protocols into existing workflows and standardize the approach to care.
Monitor and evaluate the adherence to clinical protocols, providing feedback and implementing improvements as needed.
Establish systems for accurate and timely data collection related to clinical cases.
Analyze condition/disease-related data to identify trends, areas for improvement, and opportunities to enhance patient care.

20%
Develop evidence-based protocols and clinical pathways for the early recognition, diagnosis, and management. Ensure that protocols are aligned with current guidelines and best practices to promote standardized, high-quality care delivery across all clinical settings.
Establish key performance indicators (KPIs) and metrics to track condition/disease-related outcomes, such as time to antibiotic administration, compliance with bundle elements, and mortality rates. Implement systems for real-time data collection and reporting to identify trends, monitor progress, and benchmark performance against internal and external benchmarks.
Implement strategies to enhance patient safety during clinical management, such as medication safety protocols, infection prevention measures, and risk mitigation strategies for potential complications. Conduct root cause analyses and adverse event investigations to identify system failures and preventable errors, implementing corrective actions to prevent recurrence.
Facilitate the preparation for and participation in condition/disease-related audits and inspections.
Lead interdisciplinary quality improvement teams focused on addressing gaps and opportunities for improvement in clinical care delivery. Collaborate with frontline staff to implement process changes, workflow optimizations, and educational interventions aimed at enhancing adherence to evidence-based practices and improving patient outcomes.

20%
Collaborate with healthcare professionals, including physicians, nurses, and other stakeholders, to establish program goals and objectives.
Develop and deliver educational programs on condition/disease prevention, early recognition, and evidence-based treatment for healthcare staff.
Conduct regular training sessions to ensure that staff members are knowledgeable about clinical protocols and guidelines.
Foster collaboration among different departments and healthcare professionals to ensure a coordinated and multidisciplinary approach to condition/disease management.
Communicate regularly with hospital leadership, staff, and relevant stakeholders to provide updates on program progress and outcomes.
 

Qualifications

Experience: Minimum of 5 years of clinical experience in a healthcare setting, with a focus on condition/disease care and quality improvement.
 

Education: Bachelor's Degree required
 

Certification/Licensure: RN license
 

Knowledge/Skills/Abilities: Performance Improvement, Strategic Thinking, & Change Management