Fallon Health Rehabilitation Manager-Summit ElderCare-Springfield in Springfield, Massachusetts
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.
About Summit ElderCare :
Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon’s PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities.
Summary: Responsible for the oversight of the site specific Rehabilitation Department. Oversees rehabilitation services provided to SE participants in accordance with applicable regulations as well as FH and SE policies and procedures. Responsible for assuring that the rehabilitation needs of participants are assessed and met either through the use of SE staff or through coordination of care with contracted vendors. Performs assessments, participates in care planning and provides direct care for program participants.
Primary job responsibilities:
Performs all managerial functions to ensure adequate and appropriately skilled staff and resources are available to provide all PACE related services, including but not limited to, hiring, training and evaluation of rehabilitation services personnel.
Coordinates the provision of rehabilitation services.
Assures that assessments are completed and documented to identify rehabilitation service needs in a timely manner.
Works in collaboration with the interdisciplinary team (IDT), participants and caregivers to determine and meet participants’ rehabilitation needs.
Participates in daily IDT meetings and care planning meetings as scheduled.
Assures that care plan revisions are documented in the participant’s record and communicated in a timely manner; supervises implementation as necessary.
Documents all direct care encounters in the EMR to facilitate submission of claims and diagnostic data to FH systems.
Delegates work to SE rehab staff according to their scope of practice, by establishing work assignments and coordinating staff schedules.
Assures assessment and treatment of participants in their home setting as needed.
Collaborates with the Home Care Manager to assure that home safety evaluations are completed in a timely manner, information is communicated to the IDT and follow-up of identified recommendations occurs.
Collaborates with the Home Care Manager to assure in-home equipment needs are met.
Develops and implements processes for managing in home equipment quality and cost management.
Completes all rehabilitation services related data collection and quality surveillance as required.
Conducts regular staff meetings and staff supervision as appropriate.
Role model for staff
Responsible for the timely completion of staff touchpoint meetings, performance evaluations and competencies. Addresses employee relations and performance issues immediately and directly
Responsible for ensuring timely and accurate review of rehabilitation service claims and prior authorizations and submission of approvals to the FH Claims Department.
Assures that corrective action plans are completed for incident/grievance reports related to rehabilitation services.
Performs all other duties as assigned.
Education, Licenses, certification and experience requirements:
Education: Graduate of an accredited rehabilitation program in Physical or Occupational Therapy * *
License: Licensed as a physical or occupational therapist in Massachusetts * *
Certification: CPR certification or willingness to obtain
Experience: At least one year experience working with a frail or elderly population in a health care setting. * * At least 2 years management or supervisory experience preferred. Experience in home or outpatient settings preferred. PACE experience preferred.
Reports to: Site Director
Direct reports: SE rehabilitation services staff
Collaborates With :Providers, Interdisciplinary team members, Director of Quality & Risk, participants and caregivers, community partners
Demonstrates commitment to the Fallon Health Mission, Values and Vision.
Specific competencies essential to this position:
Customer Focus * *
Leadership Presence * *
Uses Systems to Achieve Results
Clinical skills sufficient to meet the requirements of the position * *
Utilization Management * *
Key "Must Haves"
Needs to be a PT or OT
At least one year experience working with a frail or elderly population in a health care setting
Strong Leadership skills
Able to manage a panel of ppt's and lead/direct team
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.
Posted Date 1 month ago (12/7/2020 6:25 PM)
Job ID 6160
# Positions 1
Category Medical Management