Location: CHA East Cambridge Care Center
Category: Professional and Management
Department: CHA PACE
Job Type: Full Time
Union Name: Non Union
Work Schedule: Day
Length Of Shift(s) In Hours: 8
Shift Details: Monday - Friday, 8:00am-4:30pm
Hours/Week: 40.00
Weekend Requirements: NA
Holiday Requirements: NA
On Call Requirements: 3-4 weeks per year on-call, which may include a holiday
Position Summary
The PACE Program Manager - Interdisciplinary Team (IDT) is a key operational and clinical leader responsible for the effective management and performance of an assigned interdisciplinary team within CHA PACE. Serving as the team's operational leader and expert in the PACE model of care, the Program Manager ensures the delivery of high-quality, participant-centered care while maintaining compliance with applicable Centers for Medicare & Medicaid Services (CMS), state, and PACE program regulations.
This role provides leadership and oversight of interdisciplinary care coordination, team operations, quality improvement, and regulatory compliance. The Program Manager facilitates effective team collaboration, addresses complex participant care and staffing concerns, and promotes accountability and continuous improvement.
Working closely with the Program Director of Quality and Safety and other PACE leaders, the Program Manager supports quality and compliance initiatives through data collection and analysis, incident investigations, root cause analysis, audit preparation, and implementation of improvement strategies.
The ideal candidate is an experienced healthcare professional and collaborative leader who thrives in a complex, interdisciplinary environment and is passionate about improving the health, well-being, and independence of older adults.
Key Responsibilities
Interdisciplinary Team Leadership and Operations
• Serve as the primary operational leader and PACE model of care expert for the assigned interdisciplinary team, functioning in the capacity of a Center Manager.
• Lead and facilitate interdisciplinary team meetings, care planning, and care coordination processes to support comprehensive, individualized participant care.
• Promote effective communication, collaboration, and accountability among team members and across disciplines.
• Provide guidance and support in resolving complex participant care concerns, staffing challenges, and operational issues, prioritizing participant safety, satisfaction, and quality outcomes.
• Facilitate communication among participants, families, caregivers, and providers to promote shared decision-making and participant- and family-centered care.
• Collaborate with other PACE leaders regarding staff performance, disciplinary matters, and discipline-specific concerns.
• Participate in the administrator on-call rotation.
Quality, Compliance, and Regulatory Oversight
• Maintain expert knowledge of PACE regulations, requirements, and operational standards, and serve as a resource for staff regarding regulatory expectations and the PACE model of care.
• Monitor the assigned IDT's compliance with CMS, state, and PACE reporting requirements, ensuring accurate and timely submission of required documentation and reports.
• Oversee required reporting and follow-up related to participant grievances, service determination requests, Level II root cause analyses, state critical incident reports, and other quality and compliance activities.
• Educate staff on regulatory requirements, policy and procedural updates, and changes in operational practices.
• Lead or support staff training initiatives related to quality, safety, and regulatory compliance.
• Participate in mock audits, medical record reviews, and other compliance monitoring activities; identify gaps and recommend corrective actions.
• Support preparation for CMS audits and actively participate in audit activities, including follow-up and resolution of identified findings.
Participant Concerns, Grievances, and Service Determinations
• Lead timely investigations and resolution of participant concerns, complaints, and grievances for the assigned IDT.
• Coordinate investigations through participant and family communication, staff interviews, collaboration with contracted providers, and medical record review.
• Partner with the Program Director of Quality and Safety to develop written responses and correspondence to participants and families.
• Oversee the processing of service determination requests, ensuring appropriate documentation, timely communication, and issuance of required participant notifications.
• Collaborate with the Program Director of Quality and Safety to support the appeals process, when indicated.
• Identify opportunities to improve the participant experience and strengthen communication and service delivery.
Data Management and Quality Improvement
• Maintain accurate, complete, and reliable quality and compliance data for the assigned interdisciplinary team.
• Monitor and analyze key operational and quality indicators, including emergency department utilization, hospitalizations, on-call activity, care plan accuracy, service determination requests, and grievances.
• Participate in CHA PACE Quality Improvement Committee activities, including meetings, data collection, trend analysis, and reporting on quality improvement initiatives.
• Identify patterns, emerging risks, and opportunities for improvement; develop recommendations and support implementation of corrective and preventive actions.
• Participate in root cause analyses and follow-up activities related to critical incidents, sentinel events, and other high-risk situations.
• Promote a culture of continuous quality improvement, regulatory accountability, participant safety, and operational excellence.
Additional Responsibilities
• Support special projects and organizational initiatives as assigned.
• Perform other duties consistent with the scope and responsibilities of the position.
Qualifications
Education/Training
• Bachelor's degree in a related field. Equivalent experience may be substituted for a degree.
• Degree in a PACE-related field is highly desirable.
Work Experience
• 5-7 years of healthcare experience, preferably in a PACE program.
• Team management or coordination experience, especially with interdisciplinary teams.
• Knowledge of data collection and analysis.
Please note that the final offer may vary within the listed Pay Range, based on a candidate's experience, skills, qualifications, and internal equity considerations.
