Position Summary

The Chief Operating and Nursing Officer (COO/CNO) is a key member of the Executive Team. In this capacity, the COO/CNO is integrally involved in strategic planning and organization-wide decision-making. The COO/CNO reports directly to the Chief Executive Officer (CEO).

The COO/CNO develops and implements the organization’s plan for providing nursing care to patients. This involves developing the organization-wide patient care programs, policies, and procedures that describe how nursing/patient care is assessed, interventions planned and provided and outcomes evaluated. The primary responsibility is for the quality of nursing care and is expanded to other clinical entities, thus, assuring efficient and effective coordination and delivery of patient care services. Plans, directs, and coordinates activities of multiple clinical departments in the medical facility to maintain standards of patient care, and advises CEO in matters related to clinical operations. This position is responsible for all matters affecting the day-to-day operations of the hospital, as well as in planning for the future, and in establishing community linkages for health improvement. It is expected that this position participates with leaders of the Board of Directors, Executive Team, management team, and medical staff in planning, promoting, and conducting hospital-wide quality assessment and performance improvement activities.

Essential Duties And Responsibilities

  • Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g., Medicare and Medicaid) regarding fraud, waste, and abuse. Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff. Takes appropriate action with concerns reported by department staff related to compliance.
  • Purposefully conducts all aspects of the job in an ethical manner in support of the hospital’s commitment to ethical behavior in all areas of personal and professional activity.
  • Ensures organizational continuity within the limits authorized by policies, procedures, and budgets.

Develops and implements strategy.

  • In close cooperation with and subject to the approval of the CEO, works with senior management to establish objectives for the hospital and its operating departments toward the improvement of hospital services.
  • With department leaders , formulates departmental objectives: proposes new services and programs; determines personnel needs and space requirements for existing and proposed programs; reviews and makes recommendations to the Executive Team.
  • Communicates hospital objectives, strategies, and plans to directors, managers, and staff.

Manages operations of patient care, professional, ancillary, and general services.

  • Establishes effective controls for monitoring performance to establish standards/metrics.
  • Ensures that clinical services meet or exceed established standards of care/metrics/core measures.
  • Ensures that financial outcomes meet or exceeds established targets.
  • Consults and collaborates with physicians and clinical departments in establishing policies/standards/procedures, and quality outcomes for patient care.

Develops, coordinates, and provides leadership to patient care services.

  • Develops and directs the departments within the scope of patient care services and establishes the responsibilities of positions reporting directly to the COO/CNO.
  • Selects, motivates, and guides patient care services leadership team in the achievement of the hospital’s strategic plan.
  • Delegate’s authority commensurate with the responsibilities of patient care services leadership positions; ensures that the scope of authority is clearly defined and understood; monitors direct reports performance and provides support and assistance as needed.
  • Assures front-line participation in clinical decision making by establishing shared governance.

Ensures the effective recruitment, selection, supervision, development, and retention of patient care services management and employees.

  • Ensures the department directors/managers and other hospital staff are well qualified.
  • Provides input and oversight of department/service line director’s performance relative to budgets and objectives. Assists directors in identifying ways of improving their performance.
  • Collaborates with Human Resources on salaries and benefits for clinical personnel to ensure that they are commensurate with qualifications and in line with positions of comparable responsibilities within the organization and community.

Serves as a member of the Executive Team.

  • Provides input to the CEO regarding patient care activities, strategies, and other matters.
  • Works in tandem with the Executive Team to create a collaborative multidisciplinary environment.
  • Serves as staff to the Board of Director s (Board) and committees of the Board to provide clinical input required to make Board decisions.

Other Responsibilities And Duties.

  • Attends various meetings of the Board, medical staff, and other groups as determined by the CEO and the Executive Team.
  • Represents the hospital as assigned by the CEO.

Ensures rational and purposeful management of patient care through the application of sound planning and goal setting principles.

  • Facilitates a multidisciplinary approach to patient care.
  • Plans change and the successful implementation of new ideas.
  • Coordinates the development of annual goals for areas of direct accountability.
  • Leads the development of the house-wide performance improvement plan and safety plan.

Promotes sound fiscal operations by implementing an effective budgeting process.

  • Facilitates development of annual revenue, personnel, and operating and capital expense budgets for Core Services and service lines.
  • Analyzes available financial data for significant variances.
  • Identifies data and trends to be used for future budget planning and impacts on strategic planning.

Assures effective leadership and management of assigned departments/service lines through the application of management principles within established guidelines.

  • Establishes productivity guidelines for departments.
  • Assures that all job descriptions within the area of responsibility clarify and delineate position expectations.
  • Facilitates the completion of annual performance appraisals for all staff in areas of accountability.
  • Creates an environment for staff growth and development.
  • Creates an environment that recognizes and values differences in staff, physician, patients, and communities.
  • Ensures staff alignment and engagement through participative decision making and shared governance.

Reviews, reports, and adjusts practices in the hospital in order to meet necessary regulatory and legal standards.

  • Actively provides administrative input for the planning and monitoring of quality improvement, risk management, and infection control.
  • Assures compliance with federal, state, and local laws and regulations.
  • Effectively prepares and complies with mandatory and voluntary accreditation as accepted by the hospital (this may include The Joint Commission (TJC), Det Norske Veritas (DNV), Centers for Medicare & Medicaid, Services (CMS), Department of Human Services (DHS), etc..

Ensures well integrated and organized delivery of services through effective intra and inter-departmental coordination.

  • Facilitates a multidisciplinary approach for patients through the continuum of care.
  • Facilitates cooperative formal and informal working relationships between departments and medical staff.
  • Works with the Chief Medical Officer (CMO) to ensure a collaborative working environment for all practitioners.

Maintains and promotes a personal, professional philosophy of community involvement by participating in professional and community activities.

  • Represents the organization on health-related topics and issues through community involvement and Board participation.
  • Serves as a good community citizen through support of nonprofit organizations that contribute to a quality lifestyle that is attractive to the current and future work force.
  • Participates in health related activities and groups.
  • Participates in professional organizations.

Position Requirements

  • Education
    • Undergraduate nursing degree required. Master’s degree in nursing required.

  • Qualifications/Experience
    • Progressive leadership experience with minimum of five to ten years in an operations position; three to five of these years as a Chief Nursing Officer with responsibility for non-nursing clinical departments.
    • Experience in a safety net organization preferred.
    • California state RN license.
    • ANA Certification in Nursing Administration preferred.

  • Special Skills/Knowledge
    • Excellent communication skills and evidence of collaborative practice. History of successful clinical and fiscal outcomes. Expertise in healthcare delivery systems and performance improvement. Knowledge of TJC and federal and state regulatory standards is required. Basic competency in email, word processing, Excel and internet programs.
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