Summit Eldercare Assistant Site Director-grove - Worcester, United States - Fallon Health

Fallon Health
Fallon Health
Verified Company
Worcester, United States

3 weeks ago

Mark Lane

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Mark Lane

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Description

Overview:

About us:

Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve.

Founded in 1977 in Worcester, Massachusetts, we deliver equitable, high-quality coordinated care and are continually rated among the nation's top health plans for member experience, service, and clinical quality.

Fallon Health's Summit ElderCare is a Program of All-Inclusive Care for the Elderly-PACE for short.

PACE, an alternative to nursing home care, is a program that helps people 55 and older continue living safely at home.

At Fallon Health, we believe our individual differences, life experiences, knowledge, self-expression and unique capabilities allow us to better serve our members.

We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status and other characteristics that make people unique.


Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE— in the region.


Brief summary of purpose:


Works closely with SE Site Director to provide day to day oversight of PACE operations for assigned PACE site of 400 or more participants.

Responsible for coordination and supervision of all clinical staff, financial, and business aspects of a PACE team of 200 participants or more.

Manages all administrative functions related to running a PACE center. Responsible for hiring, training, supervision and retention of support/administrative staff, Supervisor of Recreational Activities and Registered Dietitians. Responsible for oversight of all PACE center staff in the absence of the Site Director.

Oversees the timely and accurate processing of claims, data collection and reporting including those related to the Electronic Medical Record (EHR).

Assures that all functions are completed in an accurate and timely manner. Maintains a positive, professional, collaborative relationship with staff and vendors.

Ensures all Level one and two incidents and grievance investigations and reports are filed in a timely manner in accordance with PACE regulations and SE policies and procedures.

Oversees Acts as PACE site Transportation Coordinator and oversees the provision of transportation services for all site participants.

Responsible for all site facilities management, working closely with Director of Facilities to ensure all systems are working properly and all equipment is maintained according to the prescribed schedule.

Acts as SE liaison to site vendors.

Works closely with Outreach & Enrollment staff to ensure the intake process flows smoothly, to ensure prospects are scheduled in a timely manner and the team is prepared for swift enrollment decisions.

Acts as back up to Site Director in his/her absence.

Oversees the site Activity program working closely with the Supervisor of Recreational Activities to ensure age-appropriate, interesting and varied activities are available for participants on a daily basis Oversees the Registered Dietitians to ensure timely regulatory assessments.


Responsibilities:


Primary Job Responsibilities

  • Provides oversight of daytoday PACE center operations in collaboration with SE Site Director acting as primary back up in his/her absence.
  • In collaboration with SE Site Director, analyzes and manages utilization metrics and targets to ensure favorable financial outcomes.
  • Oversees Manages Incident and Grievance reporting for the PACE site ensuring all reports are filed and completed in the established timeframe.
  • Oversees Responsible for all Level one and two investigations and reports working closely with assigned Quality RN.
  • Manages all supervisory functions for site based Registered Dietitians, support staff and Supervisor of Recreational Activities including hiring, training and performance management. Completes annual employee evaluations and competencies. Conducts monthly staff meetings. Conducts regular touchpoint meetings with all direct reports to provide guidance and feedback on progress toward established goals.
  • Oversees intake and enrollment process for prospective enrollees, working closely with Outreach and Enrollment staff.
  • Assures that all demographic and other nonclinical information is entered into the EHR and documents are scanned according to established procedures.
  • Acts as Site Transportation Coordinator to assure safe and timely transport of all participants to/from the site, home and appointments. Meets regularly with transportation vendor to work through any issues and foster good rapport.
  • Meets regularly with vendors to ensure open communication and collaboration in service provision for participants
  • Collects and enters all data related to HPMS reporting for PACE site.
  • Oversees the timely processing of all claims and invoices and referrals, ensuring
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