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Fallon Health Program Director / Clinical Practice for Elder Program (PACE) - Great Role! in Amherst, NY, New York

Overview

About Fallon Health Weinberg - PACE:

Fallon Health Weinberg-PACE is a long-term care program for older adults who need a nursing home level of care , but wish to stay living at home and in their community. We are a Program of All-inclusive Care for the Elderly (PACE), providing complete medical care and support services so you or your loved one can remain living safely at home .

All care is coordinated and provided by an interdisciplinary team specializing in geriatric care, who work with participants and their caregivers to create an individualized care plan .

Summary:

The Program Director is responsible for oversight and administration of the Fallon Health Weinberg PACE Program. Responsibilities include effective planning, organization, administration, and evaluation of the program’s operations. The Program Director ensures decisions about medical, social,andsupportive services are made appropriately. The Program Director is also responsible for the financial operating results of the capitated payment program.

Responsibilities

Primary Job Responsibilities:

  • Directs, coordinates and evaluates the services provided by Fallon Health Weinberg PACE.

  • Responsible for the administrative, professional, clinical and operational components of the program necessary to assure a safe, effective and efficient program.

  • Assures compliance with all local, state and federal regulations governing Fallon Health Weinberg PACE. Plays a supporting role in the PACE initiative to identify new standards of practice in community based long term care.

  • Works with regulatory agencies to identify areas where waivers would allow for increased quality care with relief to the regulatory burden.

  • Delegates authority to key staff that will have responsibility for the productivity and quality of the program activities.

  • Influences and organizes the vision of Fallon Health Weinberg PACE to provide for future growth and development.

  • Facilitates strategic planning to identify and meet the short and long term business needs of Fallon Health Weinberg PACE.

  • Provides leadership in the encouragement of creativity and innovation balanced with risk management in the continuous effort to create new standards of clinical quality in the provision of long term care services to the frail elderly.

  • Accountable for the Activities of supervisory and management staff with regard to staffing, employment, and training issues. Commands respect as an administrator that strives for high levels of employee satisfaction and moral while stressing each employees’ responsibility for continuing improvement of clinical and service quality.

  • Evaluates the service area and surrounding communities for opportunities to expand and grow the Fallon Health Weinberg PACE program.

  • Assures the creation and continued compliance and improvement policies and procedures.

  • Controls the communications and public relations of Fallon Health Weinberg PACE.

  • Coordinates the governance (board of directors) activity to Fallon Health Weinberg PACE with staff authority to bring business planning and other issues and policies before the board on a regular basis.

  • Is a member of the Quality Management Committee, participates in scheduled quality assurance meetings and ensures the continual compliance of personnel required to participate and report at the Quality Management Committee meetings.

  • Is an ex-officio member of the Participant Advisory Committee (PAC)

  • Ensure that subcontractors are aware of how quality is measured and reports back to subcontractors on issues related to their performance.

  • Ensures the completeness of credential verification for new and renewing network providers.

  • Works in conjunction with medical director to approved candidates for participation in the provider network.

  • Coordinates and facilitates Management Committee meetings.

  • Interpret existing and proposed health programs as they affect the PACE model.

Qualifications

Education :

Bachelors’ degree in health related field.

Experience :Minimum of five years of health care administrative experience required including experience in managed care (Medicare and NY State Medicaid), extensive knowledge base of a coordination of care model, strong leadership experience, and financial responsibilities.

About Fallon Health

Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit fallonhealth.org.

Fallon Health Vaccination Requirements:

To protect the health and safety of our workforce, members and communities we serve, Fallon Health now requires all employees to disclose COVID-19 vaccination status. As of 2/1/2022, all roles not designated as “Remote” require full COVID-19 vaccination and Fallon Health will obtain the necessary information from candidates prior to employment to ensure compliance. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

PM18

Location US-NY-Amherst, NY

Posted Date 1 month ago (4/4/2022 10:02 AM)

Job ID 6787

# Positions 1

Category Medical Management

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