Job Summary
The Director, PACE Operations has overall responsibility for the oversight and administration of Prisma Health SeniorCare PACE. Includes effective planning, development, administration and evaluation of the organization's operations. This position is responsible for managing all aspects of the PACE program which consists of a primary care medical services, 24-hour care delivery, prevention services, a provider network, therapeutic services, day health center(s), home care, transportation, and performance improvement activities. Ensures the program complies with all Centers for Medicare and Medicaid Services (CMS) guidelines and SC Department of Health and Human Services regulations, ensures the financial viability and continued growth of the program, managing business relationships with all contracted providers, and managing state and federal relationships surrounding the PACE program. Monitors the effectiveness of the interdisciplinary team and contracted providers to ensure that all services are delivered at the highest level of customer service and quality.

Accountabilities

• Supervises leadership team and is responsible for the retention of qualified staff, ensuring that appropriate personnel perform their functions within the organization, and that staff and contract providers are properly trained on all policies and procedures. 20%
• Responsible for the financial accountability of the PACE Program. Establishes an annual operating and capital budget and a system to monitor monthly results. Develops effective controls and systems to monitor administrative costs for optimal value and operating results. 20%
• Maintains compliance with all state and federal program requirements, obtaining and maintaining certification under CMS, SCDHHS and other applicable federal and state regulations.15%
• Collaborates with the Intake Department to build program census. 10%
• Ensures that decisions about medical, social and supportive services for PACE participants are made appropriately based on identified and validated needs. Establishes an ethical framework to guide options and decisions regarding patient services.10%
• Responsible for the development and management of all external program relations. Represents the Program in the community, state and nationally and is responsible for assuring positive public relations.10%
• Serves as liaison with regulatory agencies and the national and state PACE Associations to negotiate as needed and represent the interests of the PACE Program.5%
• Negotiates provider contracts with contracted health and medical services. 5%
• Oversees quality program to ensure compliance and ongoing performance improvement.5%

Supervisory/Management Responsibilities

Job has direct and/or indirect supervision of team members that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health Company or affiliate and will have direct reports.

Minimum Requirements

BSN

5 years experience with 1 year working with with the frail or elderly population, experience in healthcare with an emphasis on a model of providing managed healthcare

In Lieu Of

In Lieu of the education and experience requirements noted above,

N/A

Required Certifications, Registrations, Licenses

SC RN License

Required Knowledge, Skills, Abilities

Master's Degree preferred

Progressively responsible experience in health care with geriatric service delivery experience preferred

Basic computer skills

Knowledge of office equipment (fax/copier)

Proficient computer skills (word processing, spreadsheets, database)

Data entry

Mathematical skills

Work Shift
Day (United States of America)

Location
15 Medical Park Rd Richland

Facility
1539 Seniorcare - Midlands

Department