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Clinic Director Salary in Houston, TX

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Assistant Manager Nursing - General Surgery
UTHealth, Houston
UTHealth Houston Department of Surgery (General Surgery) is hiring an Assistant Nurse Manager for their Bellaire location. The ideal candidate will have general surgery knowledge with EPIC experience being a plus. Position is Monday - Friday. This position is based in Bellaire with the expectation of traveling to outside multiple clinics around Houston and surrounding areas. What we do here changes the world. UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That's where you come in.Once you join us you won't want to leave. It's because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you'd expect from a top healthcare organization (benefits, insurance, etc.), plus: 100% paid medical premiums for our full-time employees Generous time off (holidays, preventative leave day, both vacation and sick time - all of which equates to around 37-38 days per year) The longer you stay, the more vacation you'll accrue! Longevity Pay (Monthly payments after two years of service) Build your future with our awesome retirement/pension plan! We take care of our employees! As a world-renowned institution, our employees' wellbeing is important to us. We offer work/life services such as... Free financial and legal counseling Free mental health counseling services Gym membership discounts and access to wellness programs Other employee discounts including entertainment, car rentals, cell phones, etc. Resources for child and elder care Plus many more! Position Summary:Responsible for ensuring safe, effective clinical nursing care for all patients. Responsible for the management, evaluation, and coordination of nursing personnel. Provides direction to operational, clinical and administrative staff in a clinic or clinics.Position Key Accountabilities:1. Assists the Nurse Manager and/or the Practice Manager/Sr. Practice Manager in the management and coordination of the daily activities for an assigned clinic(s).2. Assist in the development implementation/evaluation of unit/departmental goals. Participates in decision-making with the Nurse Manager, practice manager, medical director, and other supervisory personnel.3. Assists in resolving interdepartmental and intradepartmental problems/concerns. Actively participates in performance initiatives. Facilitates change process.4. Acts in-charge in the absence of the Nurse Manager, Practice Manager/Sr. Practice Manager or other supervisory personnel.5. Investigates, communicates and follows through on concerns expressed by patients, families and/or staff. Effectively communicates with patients, families and staff.6. Supports nursing research by participating in research activities where appropriate. 7. Participates in the continuing education process, identifies own professional needs and assists with education and orientation of clinical staff and students. 8. Manages Human Resources activities of department in regards to: recruiting and selection, hiring and terminations, training, professional development, mentoring, counseling, performance evaluations, and salary planning.9. Utilizes tools of quality improvement to collect and report quality data.10. Other duties as assigned.Certification/Skills:Current Texas registered nurses license.BLS CertificationACLS/PALS preferredCertification in area of specialty preferredMinimum Education:Bachelors degree in nursing plus three years nursing experience, ORAssociates degree in nursing plus five years nursing experience, ORNursing diploma (3-year program) plus four years nursing experience.Minimum Experience:Nursing experience preferably including some managerial/supervisory experience. The number of years varies depending on the education level attained.Physical Requirements:Exerts up to 50 pounds of force occasionally and/or up to 20 pounds frequently and/or up to 10 pounds constantly to move objects.Security Sensitive:This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215Residency Requirement:Employees must permanently reside and work in the State of Texas.
Regional Director Medical Imaging
Kelsey-Seybold Clinic, Houston
ResponsibilitiesThe Regional Director, Medical Imaging reports to Vice President of Imaging & Cardiology Services. This position will oversee the administrative, clinical, and technical operations of Medical Imaging in region of responsibility. The Regional Director, Medical Imaging will collaborate with key departments including Ambulatory Services, Information Systems, Finance, Purchasing, Human Resources, Managed Care, Marketing, Medical Records, Quality Improvement, Risk Management, Coding Compliance, and the Laboratory to meet organizational and departmental goals. Will plan and implement improvements that allow areas of responsibility to perform more effectively and efficiently; leveraging technology advancements when appropriate.Job Title: Regional Director Medical Imaging - Radiology AdministrationClinic Location: Main CampusDepartment: Radiology AdministrationJob Type: Full Time Salary Range: $136,122 - $168,137 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)This Director will oversee clinics in Memorial Villages, West Grand Pkwy, Cypress, Katy, and Westchase locations.EducationRequired: A bachelor's Degree in a related discipline, business, or management OR 7 years of multiple-modality Medical Management experience.Preferred: Master's Degree in a healthcare-related discipline, business, or managementExperienceRequired: 7 years of Radiology Management experience, including developing and monitoring the Radiology Department's Capital, FTE, and Operational budgets. 3 years of clinical experience3 years of project management experience Strong working knowledge of health care/clinical operations5 years of experience in regulatory guidelines and compliancePreferred: Previous experience as a director or manager of a multi-site Outpatient Imaging operation with Interventional Radiology/Nuclear Medicine experience. Experience in mobile imaging operationsExperience specific to TDSHS & TMBLicense(s)Required: ARRT (R)ORCertification in other medical imaging modalitiesPreferred: Additional imaging certifications ex: (M) (CT) (MR) RDMS, (NM)Special SkillsRequired: Proficient in Microsoft Word and Excel.Excellent analytic, problem-solving, and interpersonal skills.Knowledge of Radiology CPT coding and billing issues.Pro forma development.Excellent Customer Service skills.Preferred: Ability to speak/understand SpanishOther
Director of Recruiting Operations
Rice University, Houston
Position Summary: The director of recruiting operations at Rice University works under the direction of the executive director of recruiting and is responsible for planning and coordinating recruiting of student athletes for the football program. S/he partners with the recruiting staff as well as others on the coaching staff in developing recruiting strategies, in cooperation with the Head Football Coach. The director of recruiting operations also is responsible for supporting the philosophy, goals, and mission of Rice University and its intercollegiate athletics program as well as adherence to Departmental, University, American Athletic Conference, and NCAA policies and procedures as it relates to recruitment of student athletics. Minimum Requirements: Bachelor's degree in related field 1 year related professional experience in student recruitment and/or working with a collegiate or professional football program. Must possess (or can obtain one within 30 days of hire) and maintain a valid Texas driver's license with no more than three moving violations and/or at fault accidents within the past 36 months, and no convictions or deferred dispositions for Driving While Intoxicated (DWI) or Driving Under the Influence (DUI) within the past five yearsSkills: Strong verbal and written communication skills Excellent reading comprehension skills Demonstrated ability to work independently and make distinctions among competitive applicants Excellent organizational and time management skills Excellent interpersonal skills such as professionalism, collaborative, influencer and demonstrates cheerful and positive behaviors Demonstrated presentation skills Evidence of program planning and management skills Must have proper knowledge and skills surrounding the sport of football Preferences: Related experience working with a collegiate or professional football program Knowledge of NCAA Division I intercollegiate athletics rules/regulations Essential Functions: Conducts market research of assigned territories. Implements recruitment activities such as travel, tele-recruitment, online chats, and email campaigns Works with other members of the admission staff on projects related to communications, on-campus recruitment programs, internal training, general or targeted recruitment activities, or other projects as needed Reads, evaluates and makes high level recommendations on applications utilizing admissions rating system Ensures compliance with federal and state laws concerning college admission, FERPA, and affirmative action Develops and delivers outreach programs May conduct quantitative analysis of admission data Serves as a public relation and an information resource for events, meetings, committees and conferences May hire, train and supervise temporary staff and/or interns Responsible to coordinate all tours and train everyone who will encounter the potential student-athletes Plan and execute Official and Unofficial Visits with recruits Manage ARMS Recruiting software and prospect data management Manage admissions application flow for prospective student athletes Manage all compliance documents for prospective student athletes Manage NLI and GIA document execution Communicate with high school counselor and/or coach securing academic records for admissions Assist the Director of Player Personnel with identification of prospective student athletes Assist the Director of On Campus Recruiting with recruiting events Assist the Director of Player Personnel with football camps and clinics Assist the Director of Football Operations with travel related to recruiting Serve as the Rice Football liaison between high schools and junior colleges within the state of Texas as well as nationally Oversees all aspects of on campus visits for the football recruiting department. Maintains a thorough knowledge of AAC and NCAA rules and regulations as it relates to recruiting Coordinate recruiting efforts for the offense or defense as assigned by DPP. Manages (plans and schedules) all visits with High School Coaches regarding student athletes practice dates; creates the travel schedule for assistant coaches ensuring efficient use time and financial resources; ensures assistant coaches schedules comply with AAC and NCAA recruiting rules and guidelines Creates and maintains a working relationship with all high school coaches; acts as liaison between the Rice coaching staff and the high schools Coordinates the design, production and mailings of all recruitment materials and information with the graphic designer Additional Functions Manages (creates, plans, coordinates and executes) all recruiting events and visits with student athletes to Rice University such as visits on Game Day, Junior Days, and Spring Practices; conducts campus tours Monitors initial eligibility of incoming freshmen, works closely with high school counselors, clearinghouse and advisors to ensure student athletes prospects are academically eligible, and informs coaches regarding student athletes prospects SAT / ACT testing dates; ensures compliance with the scholarship count Partners with compliance to distribute application and monitor admissions into Rice University; collects transcripts and test scores of prospective student-athletes Provides updates to the Recruiting Board as set forth by the Head Football Coach Maintains a database for recruiting, summer camp records, correspondence, expense summaries, etc. Facilitates the administration of football camp, coaches' clinic, and day-to-day activities as assigned by the Head Coach; assists the camp director with summer camps and coaches' clinics Manages recruiting social media accounts (Twitter, Instagram and Snapchat) Be able to effectively communicate to high schools and junior colleges in the state of Texas and beyondRice University HR | Benefits: https://knowledgecafe.rice.edu/benefits-overview Rice Mission and Values: Mission and Values | Rice University Rice University is an Equal Opportunity Employer committed to diversity at all levels. It considers for employment qualified applicants without regard to race, color, religion, age, sex, sexual orientation, gender identity, national or ethnic origin, genetic information, disability, or protected veteran status. About Us Boasting a 300-acre tree-lined campus in Houston, Rice University is ranked among the nation's top 20 universities by U.S. News & World Report. Rice has a 6-to-1 undergraduate student-to-faculty ratio, and a residential college system, which supports students intellectually, emotionally and culturally through social events, intramural sports, student plays, lectures series, courses and student government. Developing close-knit, diverse college communities is a strong campus tradition, which is why Rice is highly ranked for best quality of life and best value among private universities.
RN Clinical Supervisor
CHRISTUS Health, Houston, TX, US
DescriptionVilla de Matel Center Please note that this position is with the Congregation of the Sisters of Charity of the Incarnate Word at Villa de Matel Center located in Houston, Texas. The Villa de Matel Center is the home for the Sisters of Charity of the Incarnate Word. It is also used as a central gathering place for the Sisters and their ministries, a retirement center for the Sisters and a retreat center for the public. You can learn more about the Sisters and all of their ministries at their website, www.sistersofcharity.org.Summary:This position with the direction of the Director of Nursing (DON) directs and coordinates the operations of the nursing department related to quality and efficiency of patient care; visits all nursing units daily to evaluate nursing care; advises and assists charge nurses with nursing and managerial problems/issues, demonstrates professional accountability for competency and growth. The Registered Nurse Clinical Supervisor assists the DON in some administrative duties, provides per diem coverages for Charges Nurses, assists Charge Nurses on clinic days, and on the floor. Requirements:A. Education/Skills:· Graduate from an accredited school of nursing· Communication skills – both verbal and written · Ability to understand medical records, physician orders and nursing care plans · Ability to communicate effectively with residents, Congregational Leadership, staff and other health care professionals. · Understanding of Catholic Health Care DirectivesB. Experience · Minimum of two years previous nursing management experience preferred · Previous human resources management experience preferred · Previous financial management experience preferred · Knowledge of drugs and treatment modalities used in geriatric practice.C. Licenses, Registrations, or Certifications: · Current RN permits or licensure issued by the Board of Nurse Examiners in the State of Texas to practice nursing. · BSN preferred. · Current certification in gerontological nursing or will obtain in one year after employment. Work Type: Full Time
Dialysis Charge Nurse - RN Chronic In-center
U.S. Renal Care, Houston
The RN Charge Nurse is responsible for overseeing nursing services each shift and functions as a nursing supervisor. This position provides daily supervision of staff on duty during operational hours. Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned. Assist with clinical and operational processes to improve patient health and minimize hospitalizations and missed treatments. Demonstrate effective use of supplies and staff labor hours. Complete and document monthly review of patient medication profiles. Administer medications as ordered by the physician. Assist physician during patient rounds and transcribe and implement physician orders timely. Assist with the implementation of anemia management and medication protocols as requested. Knowledge of and comply with federal, state, local laws and regulations, including health care professionals practice act requirements. Perform duties at all times within limitations established by and in accordance with company policy and procedures, applicable state and federal laws and regulations. May give direct patient care to the extent of performing efficient, safe dialysis, if allowed by state regulations. Responds to all emergencies in clinic. Communicate results of patient assessment, reassessment, and ongoing monitoring to the physician, team members, and others as appropriate to the individual needs of the patient. Maintain collaborative working relationship with Medical Director and physicians. Participate as a member of the Interdisciplinary team in all required patient assessment and care planning activities. Assist in orientation of new staff as a preceptor or in assigning a preceptor. Acts as resource person and participates in implementing and evaluating dialysis services and assures that policies and procedures are updated. Assists Administrator in interviewing, hiring, evaluating, and disciplinary actions of center staff
Faculty (Open Rank), Epilepsy - Neurology (MHH-Woodlands), McGovern Medical School
UTHealth, Houston
McGovern Medical School at UTHealth Houston , Department of Neurology is seeking an experienced Neurologist Assistant/Associate Professor, tenure or non-tenure track (depending on qualifications), in the clinical division of Epilepsy, Texas Comprehensive Epilepsy Program(TCEP) . The division has outpatient clinics, inpatient services, active clinical, translational, and basic research, and educates medical and graduate students, neurology residents, and fellows.The successful candidate will participate in inpatient/outpatient clinical care, research, and educational programs in Epilepsy within the Department of Neurology and act as the Director of the Woodlands Memorial Hermann EMU. The Texas Comprehensive Epilepsy Program is the largest tertiary referral epilepsy center in the Southwest United States with one of the busiest epilepsy surgery programs in the country. There is an active SEEG and MEG program with surgical options ranging from resections to DBS, RNS, and laser ablation. Clinical research programs include epilepsy mortality, treatment outcomes, neuromodulation, epilepsy genetics, fMRI, and wearable m-health technologies. The center has strong ties with Neurosurgery , McWilliams School of Biomedical and Informatics , and the UTHealth Houston School of Public Health . The fellowship program includes 6-7 positions in epilepsy, 3-4 clinical neurophysiology positions, and one position in MEG/SEEG. Position Key Accountabilities: Clinical responsibilities would include up to four days of clinic a week, up to 12 weeks of inpatient service as well as up to 12 weeks of call coverage for EEG or IOM reading. Teaching opportunities are available, including in the bi-annual 8-week epilepsy/EEG course. The position is affiliated with the McGovern Medical School, the 6th largest medical school in the nation, a robust Neurology residency program, and a growing Epilepsy Fellowship program.Qualifications: Candidates must be graduates of an ACGME-accredited neurology residency and completed a fellowship in Epilepsy and related research areas, with active board certifications, and be licensed in the state of Texas (or eligible to be licensed). Interest in clinical research is encouraged but not essential.
Compensation Analyst in Human Resources (Hybrid - Mostly Remote)
UTHealth, Houston
Position Summary:We are looking for an entry-to-mid-level compensation analyst to join the dynamic Compensation Services team in our human resources department. This employee provides technical subject matter support to the Compensation Services team in order to recruit, develop, and retain a high-caliber workforce. You will be responsible for maintaining strong relationships with business partners to achieve positive and effective outcomes in support of university and departmental business objectives. They will focus on helping to conduct and create salary surveys, and work with client groups to determine pay strategies for the University and clinics. This analyst will need to move quickly, have superior customer service and analytical skills, and be able to handle communicating with clinical and executive leadership effectively. You will also handle requests for exceptions in compensation and help administer award and bonus programs for staff.We are preferably looking for a candidate who has worked with compensation in a clinical environment, so that would be a plus. But if you have a strong human resources or a financial background, we also encourage you to apply. We need strong skills in critical thinking, data analysis, and problem-solving. It will take someone curious, who likes to uncover things similar to a private investigator, finding out everything they can to uncover a client's needs. Applicants must be skilled in and have a passion for Microsoft Excel. Must be able to do "v look-ups\
Professor, Pulmonary Medicine (Pulmonary Hypertension and BPD) - Pediatrics, McGovern Medical School
UTHealth, Houston
McGovern Medical School at UTHealth Houston , a leading academic health center invites applications for a full-time position at the rank of a Professor for the Department of Pediatrics , Division of Pulmonary/Allergy/Immunology/Sleep . The selected candidate will be board certified/eligible in Pediatric Pulmonary and contribute to the department's mission to educate health science professionals, discover, and translate advances in the biomedical and social sciences, and model the best practices in clinical care and public health through clinical service, teaching, research, administrative activities, and other services.Position Key Accountabilities: The selected candidate will participate in the clinical, teaching, and research programs of the Division of Pulmonary Medicine. The Division of Pulmonary Medicine is committed to providing the highest quality of patient care as well as conducting basic and translational research relevant to pulmonary and /or life-threatening disorders in Children. This specialist will provide consultations at various children's Memorial Hermann Hospital locations and other hospitals and will have outpatient clinic responsibilities in UT Physician clinics at the Texas Medical Center and outlying centers. Most of these services are provided in a teaching hospital with a strong academic environment as demonstrated by our Pediatric Pulmonary Medicine fellowship training program endorsed by the Accreditation Council for Graduate Medical Education (ACGME).UTHealth Houston offers an excellent benefits package, including: 100% paid medical premiums for our full-time employees. Generous time off (holidays, preventative leave days, both vacation and sick time) Increasing monthly vacation hours accrued, the longer you stay. Excellent retirement plans Free financial and legal counseling Free mental health counseling services Gym membership discounts and access to wellness programs Other employee discounts, including entertainment, car rentals, cell phones, etc. Resources for child and elder care Plus, many more! Qualifications: Texas Medical License or eligible for a Texas Faculty Temporary License. Board Certified in Pediatrics and Board Certified in Pediatric Pulmonary The ideal candidate should possess experience in managing Pulmonary Hypertension and BPD. They will eventually assume responsibility as director for our BPD program in addition to Pulmonary Hypertension program.Qualified applicants must demonstrate a commitment to excellence, discovery, and service, have the potential to be outstanding in their field of expertise, and share an interest in fulfilling the common goals of McGovern Medical School at UTHealth Houston.
Dental Clinic Manager - School of Dentistry
UTHealth, Houston
What we do here changes the world. UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That's where you come in.UTHealth School of Dentistry is hiring a Dental Clinic Manager to lead a dedicated team in providing excellent customer service and contribute to the patient, student, and team experience in supporting the dental school's mission. We are seeking an individual who is an excellent communicator and motivator to confidently lead teams by building relationships of trust, open communication, and a collaborative/cohesive team environment. Also, an adaptable individual who is comfortable managing large diverse teams while handling changing priorities. The ideal candidate will have experience within a large dental clinic office setting. Location: School of Dentistry @ 7500 Cambridge, Houston, Texas, 77054Once you join us you won't want to leave. It's because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you'd expect from a top healthcare organization (benefits, insurance, etc.), plus: 100% paid medical premiums for our full-time employees Generous time off (holidays, preventative leave day, both vacation and sick time - all of which equates to around 37-38 days per year) The longer you stay, the more vacation you'll accrue! Longevity Pay (Monthly payments after two years of service) Build your future with our awesome retirement/pension plan! We take care of our employees! As a world-renowned institution, our employees' wellbeing is important to us. We offer work/life services such as... Free financial and legal counseling Free mental health counseling services Gym membership discounts and access to wellness programs Other employee discounts including entertainment, car rentals, cell phones, etc. Resources for child and elder care Plus many more! Position Summary:Manages and supervises the administrative functions, activities, and projects of a School of Dentistry clinic including the coordination of all billing activities.Position Key Accountabilities: Manages and coordinates the activities and administrative functions of a School of Dentistry clinic. This includes establishing, reviewing, and revising policies and procedures. Supervises clerical and administrative employees to ensure the clinic operates in an efficient manner and that the patients receive high quality customer service. Manages the daily dental clinic operations including purchasing, and patient scheduling. Oversees and supervises the billing activities of the clinic and resolves any discrepancies; ensures proper billing codes are used. Remains abreast of federal, state and university policies, procedures and practices and ensures proper education and training of staff. Analyzes, evaluates, and reports statistical data to optimize the use of resources and staff. Functions as the clinic liaison to internal and external partners regarding financial and business practices, policies and procedures for the clinic. Coordinates and manages special projects in conjunction with the Administrative Manager, Department Chair and/or Program Director(s). Manages Human Resources activities for direct reports in regards to: recruiting and selection, hiring and termination, training, professional development, mentoring, counseling, performance evaluations, and salary planning. Performs other duties as assigned. Certification/Skills:Thorough understanding of CPT-4 and ICD-9 coding procedures.Minimum Education:Bachelor's degree in business or relevant experience in lieu of education.Minimum Experience:Five years of clinical management experience in an outpatient clinic.Physical Requirements:Exerts up to 50 pounds of force occasionally, and/or up to 20 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.Security Sensitive:This job class may contain positions that are security sensitive and thereby subject to the provisions of Texas Education Code § 51.215Residency Requirement:Employees must permanently reside and work in the State of Texas.
Senior Specialty Administrator - GI
Kelsey-Seybold Clinic, Houston
Scope:Plan, direct, develop and coordinate activities of the clinic(s) to ensure attainment of corporate goals and objectives Coordinate directly with the Managing Physicians to achieve the goals of the organization. Ensures proper implementation of policies and procedures related to Finance, Managed Health Care, Quality Assurance/ Risk Management, Marketing, Purchasing and Human Resources at the clinic levelEducation:Bachelor's degree or 1 to 1: substitute years of equivalent supervisory/management administrative experience.Preferred:Masters degreeExperience:Minimum of 5 to 7 years of previous supervisory/management experience or Master's Degree with 3 to 5 years experiencePreferred:Ambulatory Care Management experience.Duties:Create a results oriented work environment; delegate authority and responsibility to the staff; participate in the formulation of a workable strategic plan, that is capable of providing effective organizational results; develop short term and long term goals for the clinic, identify and implement new methods, programs, policies, procedures and techniques, to enable the organization to perform more effectively; identify and solve problems that are limited individual and organizational effectiveness; prepare and determine capacity analysis for the clinic; identify appropriate physician mix; participate and provide direction and leadership to the management team within the clinic; interact with other managers and groups internal and external to the organization; direct personnel in maintaining clinic standards; develop standards and guidelines for all physical plan and equipment, including preventive maintenance, repair and replacement.Collaborate with Managing Physician to assist the Medical Director and Department Chiefs in physician staffing and recruitment; determine and monitor the appropriate MD/Support staff ratios for each clinic; assist in maintaining standards of care for patients; monitor compliance of regulations and standards established by the clinic and various regulatory agencies; assist in obtaining and maintaining appropriate levels of accreditation.Establish and maintain control of profit and loss for the clinic; review and present capital equipment proposals; formalize and review appropriate levels of funding for each clinic; create specific objectives and performance targets for each clinic; allocate resources and focus work efforts on strategic objectives; control costs by establishing budgets and formulating compliance standards; monitor expenses and review cash flows for the clinic; pursue alternatives to generate incremental revenue, leading to improved net income; ensures that asset base will earn adequate financial returns after accounting for maintenance, replacement and upgrades.Works with Purchasing Manager and Facilities departments to ensure equipment and facilities needs are appropriately procured; secures necessary supplies and equipment with assistance from the Purchasing department; monitors supplies and equipment expenditures and works closely with Purchasing department following clinic policy and guidelines.Ensure timely and ongoing plan information is communicated throughout the clinic; work directly with managed care department in ensuring operational objectives are being met to support contractual agreements; provide for continued training and development in area of managed care contracts; ensure clinic compliance with all managed care contractual agreements.Special SkillsStrong working knowledge of healthcare/clinical operations, ability to create efficient process to streamline clinic flows, physician relationship management and astute in clinic budget management.Strong organizational skills, excellent interpersonal and analytical skills. Management of a minimum 25 providers with 100K/ office visits per year at assigned clinic