Care Team Manager

About the role

Join BoldAge PACE as a Care Team Manager and lead the PACE Interdisciplinary Team (IDT). This role focuses on managing, coordinating, and facilitating the IDT to develop and implement personalized care plans that enhance the quality of life for seniors, enabling them to live independently with dignity.

Responsibilities

• Manage the care provided by the interdisciplinary team (IDT), including assessments, care plan development, and implementation of all care plan interventions.
• Facilitate interdisciplinary team meetings, ensuring communication of participant changes, collaboration on care planning decisions, and coordination of 24-hour care delivery.
• Ensure the team’s processes and decision-making meet regulatory and quality standards, aligning with the PACE model and the organization’s core values.
• Oversee the implementation and documentation of all participant care plan interventions, including specialist recommendations, diagnostic results, and hospital discharge instructions.
• Provide management oversight to IDT members, offering guidance, feedback, and support in their provision of participant care.
• Actively communicate relevant issues to the team, ensuring all members are informed and up to date, and participate in the development of the plan of care.
• Monitor and articulate participant progress and decline, ensuring optimal participant experience and clinical outcomes.
• Monitor IDT operations for compliance with established quality assurance standards, auditing documentation regularly and providing feedback to staff.
• Address and ensure the IDT promptly resolves all participant issues to maintain high-quality care.
• Review high-risk participants daily and ensure the IDT closely monitors their status and intervenes as needed.
• Function in the Center Manager role on the IDT (per CMS regulations) and fill the role of other IDT members according to competencies and qualifications.
• Ensure close follow-up of institutionalized participants (acute care, nursing home, assisted living) to promote optimal clinical care and outcomes.
• Maintain communication with all facilities providing services to participants and ensure documentation is included in the PACE medical record.
• Review and discuss participant experience outcomes (hospitalizations, emergency care, home care, etc.) regularly with the IDT and administration to problem-solve and plan for service improvements.
• Recommend changes in service delivery and staffing as required by the development and growth of the agency.
• Participate regularly in all quality assurance/quality improvement committees as part of the overall quality improvement program.
• Ensure all activities and operations comply with local, state, and federal contracts, regulations, laws, accreditation, protocol, licensing, and certification requirements governing PACE operations.
• Monitor operational compliance with OSHA regulations and agency policies and procedures.
• Protect the privacy and confidentiality of all company procedures and information about employees, participants, clients, or families.
• Participate in continuing education classes and required staff and training meetings.
• Maintain professional affiliations and any required certifications.
• Provide administrative on-call coverage on a rotation basis.
• Ensure participant medical records and demographic information are maintained and updated.
• Perform related duties as required or requested.

Requirements

• Minimum of 5 years working in a healthcare setting.
• 3 years in a healthcare-related management position (preferably in a geriatric setting).
• RN license preferred.
• 1 year working with the elderly; if not present, training on working with a frail or elderly population will be provided upon hire.

Pre-employment requirements

• Must have reliable transportation, a valid driver’s license, and the minimum state-required liability auto insurance.
• Must be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact.
• Must pass a comprehensive criminal background check that may include, but is not limited to, federal and state Medicare/Medicaid exclusion lists, criminal history, education verification, license verification, reference check, and drug screen.

Benefits

• Competitive compensation package.
• Medical and dental coverage.
• Generous paid time off.
• 401K with match (match begins after one year of employment).
• Life insurance.
• Tuition reimbursement.
• Flexible Spending Account.
• Employee Assistance Program.