TITLE:
Chief Operating Officer

THE CLIENT:
Our client, the St. Joseph’s Hospital and Medical Center (SJHMC) in Phoenix, Arizona is seeking a Chief Operating Officer for its physician practices. To better appreciate the scope and complexity of this role, one needs to understand the relationships among it, PivotHealth, and Catholic Healthcare West (CHW). 

PivotHealth is a physician practice management company, based in Brentwood, TN (www.pivothealth.com) that provides various services (through long-term management contracts, consulting, etc.) to hospital-affiliated and independent medical groups across the country. Some of their clients include: Catholic Healthcare West/Mercy Medical Group (Sacramento, CA), Advocate Healthcare Systems (Chicago), Queens Long Island Medical Group (NY), and Arnett and Elkhart Clinics (IN) to name just a few. In the case of CHW, PivotHealth has been providing services to Mercy Medical Group in Sacramento since 2001. Mercy is a multi-specialty clinic with 175 physicians spanning nine locations. CHW Medical Foundation’s employees provide the nursing, management, office staff and ancillary services at the various Mercy locations. A result of the success PivotHealth has had in Sacramento has led to their being further engaged in a long term contract with St. Joseph’s Hospital and Medical Center (www.stjosephs-phx.org) wherein they will be responsible for leading the employed physician group. 

Catholic Healthcare West is based in San Francisco and comprises a system of forty two hospitals and medical centers (www.chwhealth.org) servicing California, Nevada, and Arizona. Founded in 1986, it is the eighth largest hospital system in the country and the largest not-for-profit hospital provider in California. By the numbers, it has 8,500 acute care beds and 980 skilled beds, a network of more than 9,688 physicians and approximately 44,000 employees who provide quality health care services to more than four million patients annually. In 2007, CHW provided more than $922 million in community benefit and free care for the poor. Likewise, in fiscal year 2007, CHW reported net assets of $10.5 billion and net operating revenue of $7.5 billion. CHW maintains an “A” bond rating from Standard and Poor’s, Moody’s and Fitch Ratings.

SJHMC is a nationally recognized center for quality tertiary care, medical education and research. It includes the internationally renowned Barrow Neurological Institute, the Heart & Lung Institute, St. Joseph’s Children’s Health Center and the only Trauma Center in Arizona that is designated as a Level I Trauma Center by the American College of Surgeons. The hospital is also a respected center for maternity care, orthopedics, oncology and many other medical services. U.S. News and World Report routinely ranks St. Joseph’s among the best hospitals in the United States for neurology and neurosurgery and recently listed the hospital as one of the best for respiratory, orthopedic and endocrinology care. In 2006, St. Joseph’s celebrated its 111th anniversary by dedicating the new Barrow Neuroscience Tower, making St. Joseph’s the largest hospital in Arizona. That 430,000 square foot building houses 144 new patient beds (all of which are devoted to acute or intensive care), 48 new emergency beds, six trauma bays, eleven operating rooms, three MRIs (one surgical), a 26-bed pre-op area, and a 44-bed Post Anesthesia Care Unit. SJHMC employs approximately 4500, has a medical staff of more than 1500, and 200+ residents encompassing 12 specialties.

THE POSITION: 
The selected Chief Operating Officer will report to the Chief Administrative Officer (who, in turn, reports jointly to the CEO of SJHMC and the President of PivotHealth Management Company) and will be an employee of PivotHealth.  In general, the Chief Operating Officer will assume overall responsibility for overseeing and improving the day-to-day operations of SJHMC’s physician practices.  The COO will have direct authority over the various operations, including, but not limited to, physician/clinical scheduling, process change and outcomes management, clinic staff management, referral/utilization management, market development, etc.  The intent here is that the incumbent participate in the growth/development and operational oversight by providing effective and visible leadership. The content of this leadership is expected to include articulation of goals, facilitation of a cultural shift toward more of a “Group” mentality, enhancement of the overall performance of the various service lines, and generally mapping out and executing a multi-year plan that ensures SJHMC will effectively and profitably attract and retain new patients, physicians and staff. Many of the incumbent’s activities will be managed through delegated authority to middle management; however, the ultimate accountability for results rests with this COO.  With that in mind, the more specific responsibilities will include (and the incumbent will be measured by their effectiveness at):

•   Assuming management oversight and supervisory responsibility for all clinical departments of the physician practices at SJHMC.  S/he will work closely with departmental leadership in improving effectiveness and efficiency, patient flow management, integrating quality initiatives; implementing operational controls that enhance staff and physician utilization, developing departmental specific planning including short and long-range goals and objectives, developing and monitoring capital, expense and revenue budgets, monitoring individual departmental overall profitability, developing/supporting overall positive patient “customer service”, etc. The intent is to make the client a “Best Practices” physician group.  Needless to say, this will require his/her working in close and harmonious collaboration with finance, IT, marketing and other key departments of the physician enterprise and Hospital.
• Directing all operations, regarding improvement initiatives including telephone issues, HEDIS scores, patient satisfaction surveys, etc.
• Overseeing the selection, employment, development, control, discharge and evaluation of all personnel in their areas of responsibility in accordance with Human Resource policies/procedures, and in consultation and close collaboration with the CAO.  S/he will be expected to ensure effective delegation to management staff, as appropriate.
• Keeping abreast of, and identifying trends in health care relative to the competitive market, economic conditions and new technologies.  S/he will be expected to work closely with the CAO, SJHMC’s Chief Financial Officer and the finance department in evaluating responses to those trends through research, feasibility and cost/benefit analyses, demographic studies, physician supply/demand analyses, utilization of health care services analyses, etc.   
• Recommending strategies for new lines of business, or improvements to existing lines of business, that would enhance services or open new markets.  S/he will be expected to work closely with the CAO, Chief Financial Officer and the finance department in analyzing financial/operational feasibility of new business ventures.
• Assuming administrative responsibility for the organization in the absence of the CAO.  Serves as a senior administrative representative of the physician practices organization both internally and externally.
• Serving as a role model to all staff in creating a quality, service-oriented group culture.
• Working with the physicians toward creating a quality and service-oriented culture.
• Assisting in the implementation of the new electronic medical record system (Allscripts)

In the immediate future, the selected executive will have been successful if s/he can effectively address the current situation/challenges:

• Financial losses need to be remedied
• Space problems need to be addressed and corrected
• Phone call “system” issues are significant and widespread
• Many service lines need closer attention in terms of growth and efficiency
• Physician compensation methodologies need revision
• Operational “horsepower” is insufficient
  

QUALIFICATIONS: 
The keys to success in this role combine a synthesis of the "right" knowledge, experience, motivation and personality. S/he will have several years of physician practice management experience, including significant knowledge of health care administration, government and healthcare fiscal regulations and reporting requirements and specifically, clinic practice operating procedures, along with credentials in financial management, computer systems/programs/applications sufficient to be an equal-at-the-table with colleagues.  Specific background in multi-specialty group practice leadership is not a requirement, but it is highly preferred.  What is important is knowledge of physician practice operations and a real understanding of the nuances and economics of physician practices.   

This is someone whose communication skills “influence with integrity” rather than demand submission.  They not only can initiate change and its follow-through, but they can also manage-the-conflict-that-surrounds-that-change. They understand: “issues management” (in addition to personnel management), mentoring, and how to work, and affect change.  Because of the political nature of this environment, a premium will be placed on personal resilience and flexibility, possession of a demanding work ethic as well as sense of humor (essential).  The extent to which this selected individual emanates these qualities, will determine his/her success.

COMPENSATION:
The compensation package will be comprised of a base salary plus bonus, probably aggregating into the $200,000 range, plus benefits. This is a very pivotal position and they are committed to assuring that the right candidate is happily on-board with a package that works for everyone involved.

CONTACT INFORMATION:
Peter A. Rabinowitz, President
P • A • R • Associates, Inc.
23 West Bay Road
Osterville, MA 02655
(508) 420-2372 (phone)
(508) 420-9268 (fax)
E-mail: peter@parassoc.com