PACE Program Manager

2 months ago

Shawnee, United States State of Kansas Full time

Employment Benefits

Comprehensive medical, mental, dental, vision, and additional coverage

Sick & Vacation leave

Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave

Paid State Holidays (designated by the Governor annually)

Fitness Centers in select locations

Employee discounts with the

Retirement and deferred compensation programs

Position Summary & Responsibilities

The incumbent is responsible for the program management of the Program of All-Inclusive Care for the Elderly (PACE) program in Kansas. Primary responsibilities include the design, development, management and oversight of program goals, procedures, objectives, grievances and appeals for the PACE program. This position involves high level interaction with PACE program providers, State agencies, Area Agencies on Aging, and the Centers for Medicare and Medicaid Services (CMS).

Job Responsibilities may include but are not limited to the following:

Program Management

Evaluating and analyzing requests, documentation, information (internal and external) and data used in determining eligibility/ineligibility access to the PACE program;

Directing contracted entities in assisting consumers in navigating through KDADS and Medicaid programs and processes, including identifying available resources and programs.

Ensuring contracted entities provide appropriate support, services, information, referral, and assistance to consumers seeking access to or information about the PACE program.

Planning, organizing, and directing the activities, policies, and compliance in managing the resources necessary to operate and maintain the PACE program.

Interpreting federal and state regulation, policies, and procedures.

Developing and implementing operational protocols for program management and service delivery and policies.

Directing and consulting with contracted health plans regarding program policies, procedures, and regulations.

Utilizing management systems and tools to address special concerns and issues and continually improve program services and procedures, to determine whether needs are being met; initiates changes to correct deficiencies; and adapts programs and services to meet changing needs.

Reviewing adverse incident reports and assigning responsibility for follow up to the appropriate program field staff.

Assisting with Corrective Action Plan (CAP) development and monitoring in the event of vendor non-compliance for PACE vendors.

Communication and Consumer Service

Developing, researching, and preparing responses to address media and legislative inquiries and the public's requests concerning agency procedures and applicable laws related to the PACE program.

Addressing and responding to complex provider and consumer issues, concerns, and special requests to ensure timely responses to complaints, grievances, appeals, questions, and inquiries.

Ensuring issues are resolved according to applicable policies and procedures and documented to support responses.

Building cooperative and collaborative relationships with agency colleagues, consumers, advocates, and other key stakeholders.

Maintain strong working relationships with relevant state agency partners.

Develop and support a network of resources inside and outside of state government who are available to assist in advancing PACE program priorities.

Awareness and Training

Develops and delivers training and awareness programs to stakeholders and agency staff relating to the PACE Program, its policies, and other applicable issues.

Responsible for leading stakeholder engagement activities and workgroups for the PACE Program.

Cooperating with public or community groups and functioning as a liaison for contractors, vendors, or providers in planning and providing effective program services; may participate as a member on national, state or local committees and organizations.

Participates in personal development training opportunities in both classroom and virtual environments

Qualifications

Minimum Requirements: 

Current valid license to work in the State of KS as a RN or LPN.

Two years of experience in providing direction necessary to implement the objectives of an agency, program, or organizational unit. Education may be substituted for experience as determined relevant by the agency.

Demonstrated ability to understand, interpret and apply Federal laws and State statutes/regulations.

Excellent interpersonal/public skills, customer service, and ability to express oneself clearly and effectively, both in writing and orally.

Ability to make sound judgement regarding quality of care and make appropriate recommendations.

Valid driver’s license.

Travel

Preferred :

Licensed Registered Nurse in State of Kansas with elder care experience/training.

Knowledge of community resources and PACE regulations.

Two years of experience in management, planning, developing, implementing, and directing programs/services for the elderly and disabled.

Experience with or work in health care setting/medical field, Medicaid Programs, or Managed Care Health systems.

Experience in the design, development and presentation of program-related information and materials to a public audience.

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