Director of Operations, Medical and Surgical

Scope of Responsibility

The scope of this position is fully integrated and spans both outpatient and inpatient settings. The Director of Operations is accountable for the financial, operational, clinical support, ancillary, and administrative performance of the assigned service lines wherever care is delivered: in HRHMG ambulatory practices and de novo sites, in hospital based outpatient departments, in procedural and diagnostic suites, and on the inpatient units, consult services, and hospital based programs of Hudson Regional Hospital (Secaucus), Bayonne University Hospital, and Hoboken University Hospital.

Service Lines in Scope
This position may be assigned to any single specialty medical or surgical service line, to any combination of service lines, or to the entire specialty and surgical portfolio, at any and all assigned locations. The listings below are illustrative of the current and planned HRHMG portfolio and are not exhaustive or limiting.

Current State (illustrative, not exhaustive)
Medical specialties, including Cardiology, Rheumatology, Endocrinology, Gastroenterology, Neurology, Nephrology, Pulmonary and Sleep Medicine, Infectious Disease, Hematology and Oncology, and Physical Medicine and Rehabilitation.
Surgical and procedural specialties, including General Surgery, Orthopedic Surgery and Sports Medicine, Bariatric and Metabolic Surgery, Vascular Surgery, Urology, Otolaryngology, Ophthalmology, Podiatry, Plastic and Reconstructive Surgery, Neurosurgery and Spine, and Interventional Pain Management.
Women health services, including Obstetrics and Gynecology, Maternal Fetal Medicine support, and gynecologic procedural services.
Behavioral health and psychiatric services, including the outpatient psychiatric practices, the Partial Hospitalization Program and Intensive Outpatient Program, the Community Mental Health Centers, and the Giant Steps program, operating in bridge with the inpatient psychiatric units at all three hospital campuses.
Hospital based and inpatient facing programs, including Hospitalist Medicine, inpatient consultative services, and the in sourcing of hospitalist coverage across the three hospital campuses.
Infusion and biologic therapy services, including the HRHMG Gout Institute and the gout and autoimmune infusion pathway, rheumatologic and immunologic biologics, and specialty pharmacy coordination.
Ancillary and diagnostic services supporting the specialty portfolio, including Laboratory, Diagnostic Imaging and Radiology, non-invasive cardiac and vascular diagnostics, Sleep Laboratory, Physical and Occupational Therapy, Wound Care, and in office procedural suites.
Planned and Future State (illustrative, not exhaustive)
Ambulatory surgery center alignment and procedural migration to the most appropriate and lowest cost site of service.
Expansion of the Institute into a broader autoimmune and biologic infusion institute with multi site infusion capacity.
Development of a comprehensive spine, joint, and musculoskeletal program integrating surgery, interventional pain, physiatry, and rehabilitation.
Cardiovascular institute development integrating outpatient cardiology, diagnostics, and hospital based cardiac services.
Women health institute development integrating obstetrics, gynecology, breast health, and related diagnostics.
Oncology and infusion expansion, including medical oncology alignment and supportive care services.
Comprehensive wound care and hyperbaric program expansion across the hospital campuses.
De novo specialty sites, acquired specialty practices, and provider infusions and diffusions executed through the HRHMG MAIDD growth model, including the integration of newly acquired management services organization practices.
Role Expectations and Key Responsibilities

The Director of Operations is expected to operate as a general manager of the assigned service lines, accountable for results rather than activity, and to lead through a disciplined daily management system.

Financial Leadership, Outpatient and Inpatient

Own the profit and loss for every assigned specialty and surgical service line and every assigned location, including budget development, monthly variance analysis, forecasting, and written countermeasures for adverse variance.
Drive contribution margin improvement through volume growth, payer mix optimization, site of service optimization, supply and implant cost control, and labor productivity.
Own provider productivity management, including work relative value unit performance, session and template utilization, panel and procedural volume, and compensation plan administration in partnership with Finance and the Chief Executive Officer.
Partner with Revenue Cycle to improve charge capture, coding accuracy, prior authorization performance, denial prevention, and days in accounts receivable for both professional and technical components.
Own supply chain performance for the assigned service lines, including implant and high cost item standardization, preference card management, vendor consolidation, contract compliance, inventory turns, and expiry waste.
Build and defend pro formas for new providers, new procedures, new equipment, new locations, and service line expansion.
Manage the financial performance of hospital based arrangements supporting the assigned service lines, including medical directorships, co management structures, call coverage arrangements, and professional service agreements, in partnership with Finance, Legal, and Compliance.
Operational Leadership, Outpatient and Inpatient

Own access performance for the assigned service lines, including third next available appointment, new patient lag, referral to appointment interval, procedure to schedule interval, and template and session design.
Design, standardize, and enforce scheduling templates, session counts, hours of operation, block schedules, and coverage models across all assigned locations.
Own patient throughput and cycle time in the ambulatory setting, including check in, rooming, provider contact, procedure, checkout, and follow up scheduling.
Own procedural and operating room block utilization, release practices, first case on time start performance, turnover time, and case scheduling accuracy for the assigned surgical service lines, in partnership with perioperative leadership at each hospital campus.
Own inpatient facing operational performance for the assigned service lines, including consult response time, rounding structure, discharge support, transfer and admission workflow, and on call coverage adequacy.
Standardize operations across all assigned sites so that a patient, a provider, or a staff member experiences the same process at every HRHMG location.
Lead performance improvement using Lean, Six Sigma, or equivalent structured methodology, with documented A3 or equivalent problem solving for every material performance gap.
Own facilities, space utilization, equipment readiness, preventive maintenance coordination, and environment of care for all assigned locations.
Serve in the operational leadership structure for emergency management, downtime, and business continuity events affecting assigned locations.
Clinical Operations, Quality, and Regulatory Compliance

Partner in a dyad model with service line physician leaders, medical directors, and site Chief Medical Officers on clinical workflow, protocol adoption, care pathway standardization, and provider performance.
Own operational readiness for all applicable regulatory, licensing, and accreditation standards, including New Jersey Department of Health requirements, Centers for Medicare and Medicaid Services conditions of participation and conditions for coverage, The Joint Commission or equivalent accreditation standards, Clinical Laboratory Improvement Amendments and College of American Pathologists standards for laboratory services, American College of Radiology and radiation safety standards for imaging, Occupational Safety and Health Administration standards, and Health Insurance Portability and Accountability Act privacy and security requirements.
Own infection prevention operational compliance, sterile processing and high level disinfection oversight, instrument tracking, and procedural safety standards for all assigned procedural areas.
Own medication and biologic handling operations for assigned infusion and office based services, including storage, temperature monitoring, chain of custody, waste, and controlled substance operational controls, in partnership with Pharmacy and Compliance.
Lead survey readiness, mock surveys, audits, payer reviews, and external inspections, and own the corrective action plan and its verification of effectiveness.
Own patient experience performance for the assigned service lines, including survey results, complaint and grievance resolution, service recovery, and closed loop communication.
Participate in quality and safety event review, root cause analysis, and failure mode and effects analysis, and implement the operational components of the resulting corrective actions.
Exercise immediate authority to suspend any workflow, procedure, or location activity that presents a patient safety, staff safety, or regulatory risk.
Ancillary Service Management

Own operational and financial performance of the ancillary services supporting the assigned specialty and surgical service lines, including laboratory, diagnostic imaging, infusion, physical and occupational therapy, cardiac and vascular diagnostics, sleep diagnostics, wound care, and durable medical equipment.
Drive in network capture of ancillary and diagnostic volume generated by the assigned service lines, and measure and reduce leakage to out of network providers and facilities.
Own turnaround time and result communication standards for laboratory, imaging, and diagnostic services supporting the assigned service lines, and hold the closed loop on critical and abnormal results.
Own infusion operations, including chair utilization, scheduling, benefit investigation and prior authorization, drug acquisition and waste, patient assistance program coordination, and nursing coverage for the Gout Institute and all other assigned infusion programs.
Coordinate with hospital based laboratory, imaging, pharmacy, and rehabilitation services to ensure the assigned service lines receive the access, turnaround, and scheduling performance their patients require.
Evaluate the business case for in sourcing versus outsourcing of ancillary services and present recommendations to the Chief Executive Officer of HRHMG.
People Leadership, Talent, and Culture

Directly supervise Practice Administrators, Practice Managers, Service Line Managers, Supervisors, and Coordinators across all assigned locations, and lead through those managers rather than around them.
Own workforce planning for the assigned service lines, including full time equivalent models, skill mix, coverage schedules, float and cross coverage pools, and reduction of agency, temporary, and overtime reliance.
Partner with Human Resources on recruitment, onboarding, competency validation, compensation administration, engagement, retention, performance management, and progressive discipline.
Establish and sustain a daily management system, including daily huddles, visual management boards, tiered escalation, and standard work for every leader in the assigned structure.
Build the leadership bench. Maintain documented development plans for all direct reports and identify at least two internal successors for key positions.
Model and enforce the HRHMG service standards, professional conduct expectations, and just culture principles at every assigned location.
Technology, Data, and Analytics

Own operational optimization of eClinicalWorks in the ambulatory environment and coordinate with hospital leadership on MEDITECH dependent workflows affecting the assigned service lines.
Define, build, and govern the operational and financial dashboards for the assigned service lines, and hold every manager accountable to a single agreed source of truth.
Partner with the Patient Access Center on scheduling protocols, call handling, abandonment rate, conversion rate, referral routing, and after hours coverage for the assigned service lines.
Support the enterprise telephony transition and any other system implementations affecting the assigned locations, including workflow design, training, go live support, and post implementation stabilization.
Ensure data integrity, documentation of assumptions, and reproducibility of any operational or financial reporting produced by the assigned service lines.
Identify and sponsor automation, digital access, self scheduling, and artificial intelligence enabled workflow opportunities that reduce administrative burden and improve access.
Growth, Integration, and Strategic Execution

Support the HRHMG growth model, internally referred to as MAIDD: Mergers, Acquisitions, Infusions of providers and their patient panels into developing practices, Diffusions of providers out of capacity constrained practices into new or low volume sites, and De Novo site development.
Conduct operational due diligence on acquisition and alignment targets, including staffing, space, volume, payer mix, systems, compliance posture, and integration cost.
Own the operational integration plan and the first 180 days of post transaction performance for any assigned acquired, infused, diffused, or de novo location.
Build and defend pro formas for new sites, new services, new provider additions, and service line expansion, in partnership with Finance.
Support payer contracting and managed care strategy with accurate volume, capacity, cost, quality, and network adequacy inputs.
Represent HRHMG professionally with providers, hospital leadership, payers, vendors, regulators, and the community.
Other Duties as Assigned

Performs any and all other job duties as assigned, at any and all assigned locations. This includes temporary or permanent assignment or reassignment to any HRHMG practice site, hospital campus, ambulatory location, administrative office, or affiliated location within the Hudson Regional Health network, and includes assuming operational coverage for additional service lines, departments, programs, projects, or leadership vacancies as directed by the Chief Executive Officer of HRHMG or designee.

This position description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the role. Duties, responsibilities, reporting relationships, and assigned locations may be added, deleted, or modified at any time at the sole discretion of HRHMG.