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Organization:
SSC-Sutter Senior Care
Position Overview:
The Senior Director, PACE provides strategic, operational, and administrative leadership for a Program of All-Inclusive Care for the Elderly (PACE) center and its associated services. The Senior Director has overall accountability for center performance, including participant experience, quality of care, regulatory compliance, financial performance, workforce engagement and leadership development, enrollment and growth, execution of organizational strategy, and operational excellence.
Serving as the senior administrative leader for the PACE center, the Senior Director partners closely with the Medical Director, clinical and operational leaders, the interdisciplinary team (IDT), and enterprise leadership to ensure the delivery of high-quality, financially sustainable, coordinated, participant-centered care that supports older adults in remaining safely in their communities.
Responsible for strategic planning and operations of the Service Line. Collaborates with the other Service Line Executives to develop, implement and achieve goals, objectives and strategic plans. Sets priorities to align with business objectives and annual plan. Establishes the direction of policies and procedures and sets a structure for providing safe working environment. Assists Directors in developing the annual operating and capital budgets. Participates in system-sponsored initiatives, establishing goals and standards to support business initiatives and to ensure the delivery of exceptional customer service and achievement of common objectives. Where this job exists at a large affiliate, as defined as: Bay Foundation, Valley Foundation, CPMC, ABSMC, SMCS and OU roles, and reports to an Executive-Path leader, the title will be Executive.
Job Description :
These Principal Accountabilities, Requirements and Qualifications are not exhaustive, but are merely the most descriptive of the current job. Management reserves the right to revise the job description or require that other tasks be performed when the circumstances of the job change (for example, emergencies, staff changes, workload, or technical development).
JOB ACCOUNTABILITIES:
The Senior Director is accountable for the PACE center operating in full compliance with federal PACE regulations (42 CFR Part 460), the PACE program agreement with CMS and the State Administering Agency, and applicable state licensing requirements. Core PACE requirements for this role include:
- Comprehensive, all-inclusive care: ensure participants receive all Medicare- and Medicaid-covered services and any additional services the interdisciplinary team (IDT) determines necessary, across the PACE center, home, and community settings.
- Interdisciplinary team: ensure the IDT is fully staffed, functioning, and completing timely participant assessments, care plans, reassessments, and documentation, in partnership with the Medical Director.
- Eligibility and enrollment: support enrollment of eligible participants (age 55+, certified as meeting nursing-home level of care, and able to live safely in the community), and maintain compliant enrollment, disenrollment, and census practices.
- Capitated financial model: manage financial performance under the Medicare and Medicaid capitation payment structure, including medical expense, utilization, third-party contracts, and solvency requirements.
- Participant rights, grievances, and appeals: ensure participant rights are protected and that grievances, appeals, incidents, and service-determination timelines are handled in accordance with PACE regulations.
- Quality and risk management: maintain an effective, data-driven quality assessment and performance improvement program, including participant safety, infection control, and emergency preparedness.
- Workforce and contracted services: ensure staff and contracted providers hold required licenses, credentials, training, and competencies.
- Audit and survey readiness: maintain continuous readiness for CMS, state, and accreditation audits and surveys, and ensure timely completion of corrective action plans.
- Governance: report to and partner with the governing body and senior leadership on program performance, risk, and strategic direction.
OPERATIONS:
- Oversees the overall operational performance of all Service Line entities.
- Monitors quality, service, finance and growth performance of Service Line entities and works with Directors/Administrators to meet goals.
- Collaborates with executive management in developing benchmarks, dashboards, reports, and tools to enhance operational efficiency.
- Establishes framework for a common Service Line governance structure, ensuring unique entity needs are considered and met.
- Monitors business processes and outcomes, recommending corrective actions and working with Service Line Directors/Administrators to ensure effective operations and quality patient care.
- Identifies and develops new programs and sources of revenue.
- Facilitates and maintains harmonious and productive working relationships with Service Line leadership, Directors/Administrators, physician partners and Sutter affiliate management.
- Collaborates with Service Line Directors/Administrators, in resolving physician partner and Sutter affiliate management issues and concerns.
- Reviews complaints and incidents, responding as appropriate and ensuring improvement plan, if needed, is developed and implemented.
Growth, Enrollment & Community Presence
- Provide executive leadership for achievement of participant enrollment and census objectives.
- Partner with outreach, marketing, enrollment, and community engagement teams to expand access to PACE services.
- Monitor enrollment pipeline, disenrollment, census, market trends, referral patterns, and barriers to growth.
- Build relationships with community organizations, health systems, physicians, senior-service organizations, government agencies, and other referral partners.
- Represent the PACE program with external stakeholders.
- Develop partnerships that strengthen awareness of PACE and improve access for eligible older adults.
- Regulatory Compliance & Risk
- Ensure center operations comply with applicable federal, state, and local PACE requirements, licensing standards, organizational policies, and accreditation or certification requirements.
- Maintain continuous survey and audit readiness.
- Coordinate responses to regulatory findings and ensure timely completion of corrective action plans.
- Promote a culture of compliance, safety, ethical conduct, and accountability.
- Identify and escalate significant operational, clinical, compliance, or participant-safety risks.
- Partner with Compliance, Quality, Legal, Risk, and clinical leadership on regulatory and operational issues.STRATEGY/PLANNING:• Works with senior leadership to develop and establish short and long-term strategic plans that complement system, operating unit or affiliate goals, including business, operations, and/or organizational priorities.• Communicates strategic plans to leaders to ensure alignment of goals.• Sets priorities to align with business objectives and annual plan.• Leads goal setting process and provides roadmap for accomplishing goals. Monitors progress, developing action plans to address issues and challenges.• Communicates affiliate, operating unit and system goals to staff, helping staff understand impact on patients, operations and resources.• Develops plan of action to address current and future resource needs in order to meet service and/or operational demands and objectives.• Identifies process improvement opportunities, and ensures action plans short/long term operational objectives.• Monitors operational trends and recurrent issues, ensuring leaders implement appropriate actions to address issues.• Actively includes other departments in the development of new or existing programs.
- Provide overall strategic and operational leadership for the PACE program and center.
- Translate organizational strategy into measurable center-level goals, priorities, and operating plans.
- Establish and monitor key performance indicators across quality, participant experience, workforce, growth, financial performance, and operations.
- Lead the center's senior management team and establish clear accountability for performance.
- Partner closely with clinical, medical, nursing, social services, rehabilitation, home care, transportation, enrollment, finance, HR, compliance, and other functional leaders.
- Participate in enterprise strategic planning and operational improvement initiatives.
- Identify operational risks and opportunities and implement timely corrective actions.
- Promote innovation and continuous improvement in the delivery of comprehensive care to older adults.
- Lead the goal-setting process, provide a roadmap for accomplishing goals, and monitor progress with action plans to address issues and challenges.
- Collaborate with other service line executives to develop, implement, and achieve goals, objectives, and strategic plans that align with business objectives and the annual plan. FINANCIAL MANAGEMENT:• Establishes overall operating and capital budget with input from management team, ensuring financial targets are achieved and variances are addressed timely.• Approves operating budgets, and capital requests.• Works with leaders to ensure achievement of financial targets via effective utilization of personnel, resources and supplies.• Monitors productivity, ensuring operational challenges are addressed timely.• Reviews financial reports and ensures corrective action plans are implemented to address unfavorable variances.• Reviews and approves employee expense reimbursements, and billing statements from vendors according to established protocol.Maintain accountability for the financial performance of the PACE center.
- Develop and manage annual operating, staffing, and capital budgets in partnership with Finance.
- Monitor revenue, labor expense, medical expenses, operating expense, and other financial performance indicators.
- Ensure appropriate staffing levels and resource allocation consistent with participant needs, census, budget, and regulatory requirements.
- Develop corrective plans to address unfavorable financial performance.
- Balance financial stewardship with quality, access, workforce, and participant experience objectives.
- Identify opportunities to improve operational efficiency and long-term financial sustainability.
- Approve operating budgets, capital requests, employee expense reimbursements, and vendor billing statements according to established protocol. PEOPLE:• Provides and fosters an inclusive work environment that encourages staff engagement and collaboration, establishing a culture of teamwork.• Manages assigned staff, makes hiring and termination decisions, and reviews and approves timekeeping records.• Establishes expectations with all direct reports, holds individuals and work teams accountable, and ensures job descriptions accurately reflect job responsibilities and expectations.• Evaluates staff performance and determines/approves merit increase. Provides constructive feedback, coaching and counseling. Implements disciplinary actions and/or performance improvement plans to achieve desired performance. May work with leaders when major disciplinary action is necessary or in consultation with Human Resources.• Provides opportunities for career development, role expansion, and cross-training.• Conducts staff meetings for informative and educational purposes.• Responds timely to alleged violations of policies, procedures, regulations and standards of conduct by evaluating or initiating investigative procedures. May consult with Human Resources or Compliance to determine appropriate course of action.• Ensures staff maintains current and appropriate professional credentials.
- Provide constructive feedback, coaching, and counseling, and implement disciplinary actions and performance improvement plans, in consultation with Human Resources when needed.
- Respond timely to alleged violations of policies, procedures, regulations, and standards of conduct by evaluating or initiating investigative procedures, consulting with Human Resources or Compliance as appropriate.
EDUCATION:
Equivalent experience will be accepted in lieu of the required degree or diploma.
Bachelor's: Health Care Administration, Public Health, Business Administration or related field
TYPICAL EXPERIENCE:
7 - 15 years of recent relevant experience.
3 - 5 years PACE Leadership experience required.
SKILLS AND KNOWLEDGE:
Demonstrated knowledge and interpersonal skills necessary to tactfully direct the efforts of diverse health professionals to meet patient and physician needs.
Considerable knowledge of federal and state licensing and regulatory standards, accreditation and clinical practice standards.
Ability to act upon difficult decisions to drive desired changes, as well as capability to lead, guide and promote a sense of shared purpose within the team.
Demonstrates credible leadership presence with the ability to respond to questions with logic, clarity, calmness and authority; and the ability to engage others.
Ability to make fiscally sound decisions that reflect corporate and service line philosophy.
Verbal and written communication skills, with the ability to convey concepts and communicate information or issues in a manner that is readily understood by management and employees.
Demonstrates effectiveness in achieving goals through individuals without having direct control of those resources.
Knowledge of emerging treads and regulatory changes, and how it impacts operations.
Job Shift:
Days
Schedule:
Full Time
Days of the Week:
Monday - Friday
Weekend Requirements:
As Needed
Benefits:
Yes
Unions:
No
Position Status:
Exempt
Weekly Hours:
40
Employee Status:
Regular
Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.
Pay Range is $165,339.20 to $264,555.20 / annual salary
The posted pay range is based on the position's primary work location. Candidates who reside and work outside of that location may be subject to a different pay range based on their work location. Candidate starting salaries consider multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. Base pay is only one component of Sutter Health’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.
