Vice President of Participant Experience in at AcuteCare Health System
NewJob Function: Executive/Management
AcuteCare Health System
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Job Description
Join BoldAge PACE and Make a Difference!
Why work with us?
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Review individual care plans, assessments, and case documentation across Social Work, Home Health, POLST, Housing, Spend Card, Psychiatric/Behavioral Health, Social Services, and Self-Pay/Spend-Down, confirming what is being put in place for each participant, validate services are delivered and identify and work to remedy gaps.
- Review and interpret financials related to all areas of oversight including auditing, monitoring and identifying areas for improvement and opportunities for cost management (PMPM clinical consumption).
- Serve as the matrixed clinical leader for Social Work, Home Health, and care planning, partnering with the VP of Clinical Excellence and Quality on practice standards and clinical direction.
- Ensure POLST data integrity, identify gaps related to completion, accuracy, and alignment with participant goals of care, closing documentation and process gaps across all service lines.
- Administer and monitor participant-facing programs including the Spend Card program and self-pay/Medicaid spend-down processes for accuracy, timeliness, and compliance.
- Provide audit data related to the Spend Card program and provide compliance data to each location and rectify any concerns, gaps, and inaccuracies.
- Formulate and implement strategies related to Home Health utilization and Participant Experience, including assessment tools and refinement, advisement of center staff, and vendor reviews and contracting.
- Oversee housing, behavioral health, and social services support, confirming appropriate referrals, interventions, and follow-through at the individual participant level.
- Translate case-level/care plans into workflow, training, and policy improvements that move outcomes forward; give staff and leaders detailed, specific feedback grounded in case-level review, providing detailed audits, findings and outcome-based changes.
- Maintain regular communication with the Chief Clinical Officer, compliance, VP of Clinical Excellence and Quality and VP of Shared Services on urgent situations, compliance concerns, and support needed to advance outcomes.
- Partner with operations, quality, and clinical leaders across the organization to maintain a consistent participant experience across all centers.
- Participate in quality improvement, audit readiness, and corrective action initiatives tied to these service lines; track results and sustain improvements.
- Master's degree in social work, LCSW preferred, alternatively Nursing, Healthcare Administration, or a related field required.
- LCSW, LMSW, RN, or other applicable clinical/behavioral health licensure preferred.
- Minimum of five years of leadership experience, geriatric care management, home- and community-based services, or a related interdisciplinary care setting.
- Experience with Medicaid spend-down processes, clinical program oversight including financials, and participant-facing social services are strongly preferred.
- Demonstrated experience directly reviewing case-level documentation (care plans, assessments, POLST forms) and driving measurable, participant-level improvement strongly preferred.
- PACE program experience is strongly preferred.
- Master’s or doctoral degree in medicine or nursing from an accredited program.
- Current BLS certification required or must be obtained within 90 days of employment.
- Minimum of five years of clinical experience, including at least two years caring for medically complex older adults; PACE, geriatrics, home-based care, or value-based care experience strongly preferred. Prior experience providing clinical leadership, mentoring clinicians, supporting or leading improvement processes preferred.
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