Voice & Swallowing Specialist - SouthPark & Fort Mill

Primary Objective

A Voice & Swallowing specialist provides computerized and endoscopic evaluations and therapy to patients referred with voice disorders, swallowing disorders, shortness of breath, head and neck cancer, and chronic cough disorders.               

Essential Functions

• Perform rigid and flexible endoscopic / stroboscopic FEES procedures with accurate and comprehensive interpretation including treatment plan establishment.
• Perform computerized acoustic analysis and therapy-based procedures
• Working seated for therapy and other procedures and for computer-based tasks including documentation of notes in EPIC, messaging in EPIC, teletherapy in MyCEENTA chart in EPIC, and e-mails.
• Utilize auditory and visual analysis during evaluations and therapy intervention.
• Provide clear verbal instructions for all procedures and interventions
• Provide written instructions as indicated for therapy-based tasks
• Complete progress-note summaries and evaluation notes in a timely manner / within 48 hours of the service.
• Dexterity of hands, arms and strength in holding endoscopic equipment during exams.
• Perform endoscopic and swallowing study examinations in the standing position for extended periods
• Assist family members in transferring patients from wheelchair to exam chairs
• Work with head and neck cancer patients for voice & swallowing disorders.
• Work with laryngectomy patients for evaluation prior to surgery and establishing alaryngeal communication post-surgery via TEP placement and management, electrolarynx communication, and HME set up. Involves extended periods of standing.
• Perform Clinical Swallowing evaluations and establish scheduling for objective testing via MBSS or FEES.
• Perform evaluation of shortness of breath (SOB), exercise induced SOB, medically based SOB or VCD / PVFM and chronic cough. Involves extended periods of standing and double scoping post provocative testing.
• Retrieve patients from waiting room for all sessions.
• Ability to meet the physical and mental demands of the position
• The ability to work on-site
• Predictable, reliable, and prompt attendance

Skills and Abilities

• Proficient in Microsoft Excel
• Proficient in Electronic Medical Record systems
• Ability to communicate professionally (written and verbal)
• Proficient in computer-based analysis of voice

Core Competencies

• Customer Service:  Making patients and their needs a primary focus of one’s actions; developing and sustaining productive patient relationships.
• Building Patient Loyalty: Effectively meeting patient needs; building productive patient relationships; taking responsibility for patient satisfaction and loyalty
• Effective Communication:  Clearly conveying information and ideas through a variety of media to individuals    or groups in a manner that engages the audience and helps them understand and retain the message.
• Initiative:  Taking prompt action to accomplish objectives; taking action to achieve goals beyond what is required; being proactive.
• Decision Making: Identifying and understanding issues, problems, and opportunities; comparing data from different sources to draw conclusions; using effective approaches for choosing a course of action or developing appropriate solutions; taking action that is consistent with available facts, constraints, and probable consequences.
• Personal & Professional Ethics:   Demonstrate integrity, resilience, accountability and ethical behavior.
• Deductive Reasoning: The ability to apply general rules to specific problems to produce answers that make sense.
• Adaptability:  Maintaining effectiveness when experiencing major changes in work tasks or the work environment; adjusting effectively to work within new work structures, processes, requirements, or cultures.
• Building a successful team:  Using appropriate methods and a flexible interpersonal style to help build a cohesive team; facilitating the completion of team goals

Clinical Competencies

• Flexible and rigid endoscopic procedures and interpretation
• Clinical swallow and oral motor examinations
• Acoustic analyses
• FEES and MBSS procedures
• Evaluation and therapeutic intervention for voice and swallowing disorders
• Circumlaryngeal massage and / or myofascial release
• Prefer FEES training, RVT training, LSVT certification, MDTP certification
• Laryngectomy care / establishment of alaryngeal communication / TEP placement and trouble shooting
• Provision of teletherapy services
• Experience with VCD / PVFM / disordered breathing / chronic cough
• Knowledge of appropriate use of PPE for various procedures
• Knowledge of disinfecting rigid and flexible scopes and procedure room surfaces
• Knowledge of Cidex testing and leak testing for flexible scopes

Training Period

A Voice & Swallowing Specialist will require 3 months of training, including gradually establishing a case-load of patients after the first month of training. Establishing a patient caseload is dependent on credentialing and this will be closely tracked during the orientation period. Orientation will involve observation of the team during all types of evaluations and therapy sessions including telehealth sessions. It will also involve beginning to work with established patients while being observed by team members. Endoscopies require competencies (separate document) and will begin with scoping normal subjects including staff members. These procedures then will be trained with patient caseload once competencies for normal scoping is reached. By the end of the third month providers must meet competencies for endoscopy with patients. The new employee will also be working with their own full caseload at this time.

Accountability

Our mission is to be the premier eye, ear, nose, and throat group providing comprehensive, quality, and ethical healthcare to all in the Carolinas; to provide a favorable environment for the delivery of healthcare; and to provide for the wellbeing of the physicians and the employees of Charlotte Eye Ear Nose & Throat Associates, P.A.

Employees of the Voice & Swallowing Department provide specialized and high-quality care to both adults and children referred for disorders affecting voice or swallowing functioning. Patients receive comprehensive and extensive evaluation procedures to assist the referring physicians with diagnoses and to further assist in establishing plans of care and follow-up. CEENTA receives payment for these services via application of specific CPT codes associated with a variety of procedures with an annual budget of approximately $700,000.00.

Education

Master’s degree or Ph.D. in Speech Language Pathology

Experience

Three years of experience is preferred for a Certified Voice Specialist. For a new graduate beginning their clinical fellowship year, at least one full-time externship in the area of voice & swallowing is required.

Certificates, Licenses, Registrations

Certified and practicing specialists must have a Certificate of Clinical Competence in Speech Pathology awarded by the American Speech Language and Hearing Association (ASHA). They must have licensure in the state of North Carolina. A new graduate must have all the requirements from ASHA to begin their Clinical Fellowship year and a temporary NC license.

Work Environment

The work environment characteristics described are representative of those an employee may encounter while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The Voice and Swallowing Specialist must perform computer-based analyses and therapy intervention methods, as well as documentation of all evaluations and therapy sessions in EPIC.  The employee must be able to stand and walk to various procedure rooms and to and from the waiting room with patients. They must be able to perform endoscopies with good manual dexterity using both flexible and rigid scopes, save and retrieve the videos, provide verbal explanations of evaluations and therapy procedures and assess patient performance with acute visual and auditory skills. Providers must be able to administer topical Lidocaine spray, Afrin sprays, and Lidocaine gel as needed for procedures. Providers must be able to follow all regulations for disinfecting endoscopic equipment and general room contact surfaces. Employees must be aware of how to handle Exposure to disinfecting hazardous solutions such as Enzymatic cleaner, Cidex, Cavi Wipes and alcohol wipes.

COVID procedures:  See separate Voice & Swallowing Guidelines.  Providers may wear N95 masks, surgical masks, face shields, gowns and head-covers as they deem necessary. These are not required at this time.  Various procedures will require use of some of these protective gear and procedures.  Procedures for using the HEPA filters in endoscopy rooms is currently optional.  

Supervisory Responsibilities

A Voice & Swallowing Specialist reports to the Manager of Voice & Swallowing. Supervisory responsibilities may exist for students interns and for Clinical Fellows if hired directly from graduate school.

Position Type and Expected Hours of Work

This position can be either a full-time or part-time exempt position. Work schedules may vary but will always include 7 hours of intervention and 1 hour of documentation / administrative time for a full-day schedule and 4 hours of intervention on half-days.

Physical, Mental & Other Requirements

The physical and mental demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Strength guidelines: The maximum amount of weight an employee may be asked to lift during a normal day is 20 lbs.
• Motion parameters: Employees must be able to sit in front of a computer on and off during the day varying between, sitting during patient care, computer work and documentation. Walking between rooms designed for various procedures, standing for 15-45 minutes during endoscopy procedures or evaluations, holding an endoscope in the upright position for up to 20 minutes during patient scoping, typing, and repetitive clicking of a mouse.
• Mental requirements:  Employee must demonstrate the ability to problem solve, ability to make quick decisions, ability to ensure patient safety during procedures and tasks, ability to handle emergent patient situations, ability to supervise others, ability to thrive in fast-paced environment, ability to use discretion and sensitivity, ability to interpret data, and interact with patients, family and colleagues appropriately.

 Other Requirements: 

• Active & Current Driver’s license 
• Clean driving record 
• Consistent and Reliable Transportation  
• Polite and professional disposition  

Travel

Travel may be required between the main office at SouthPark and satellite offices. Currently the only satellite office is in Concord, NC.  Expansion to Fort Mill, SC is expected. Additional satellite offices may be established.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. In addition to those essential functions identified above, individuals in this position are also responsible for performing other duties or tasks that may be assigned.

CEENTA retains the discretion to ad or change the essential job functions of this position at any time without notice.

A Typical Day in the Position

The day begins with logging into the computer, checking the patient schedule and any e-mail messages, phone messages, or any messaging from patients sent via EPIC. E-mail messages of immediate concern will be addressed followed by patient messages. Once the patient schedule for the day is checked, materials or supplies needed to work with the first several patients is organized. Typically, there will be a mix of voice evaluations, voice therapy, Clinical swallowing evaluations or swallowing therapy sessions on the schedule. These sessions will last anywhere from 30 minutes to 90 minutes depending on the type of treatment or intervention. Some coordination with other team members may be needed in terms of use of the two procedure rooms or the treadmill room. Our administrative assistant will often communicate with us during the day about patient care needs or schedule adjustments as they arise. Patients are provided with information and exercises during their sessions and these are provided in writing. Patients are provided with general written information about their disorder and the planned treatment protocols, our contact information, and any insurance information provided to us by their particular health insurance company (evaluations only). During each session the clinical note which has been opened in EPIC will be accessed to begin inputting information. During the 12:00pm to 1:00pm time period, there is time for lunch and any unfinished documentation that is needed. Once documentation for each patient is complete, the charges are entered to complete the visit. A similar patient caseload is scheduled for the afternoons. Tuesdays during the lunch hour, we have voice rounds with a physician to go over the examinations (videostroboscopies) for any new patients referred by him/her from the last week and any other cases that we would like input on.

Other schedules include a once per month Botox clinic where we share evaluations for all patients scheduled for this treatment with a physician in his/her clinic.  Modified barium swallow studies are scheduled to be performed every Tuesday both morning and afternoon in the CT area. There is an extended lunch hour every two months to accommodate a staff meeting.

Once all notes are complete and no other tasks are required for the day or requested by the manager, the day is complete.

We do expect adjustments to the daily schedule depending on cancelations or emergent work-in patients (generally laryngectomy patients).  Periodically we will have new CEENTA employees or students observe us during our clinic. We also contract with various universities as a student internship program site and will have a full time or part time student for an entire semester.