About Fallon Health:
Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation’s top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.
About Summit ElderCare:
Fallon Health operates the largest Program of All-Inclusive Care for the Elderly (PACE) in New England and the fifth largest in the country. Called Summit ElderCare, Fallon’s PACE helps provide older adults and their caregivers with a welcome alternative to nursing home care. Participants in Summit ElderCare have access to comprehensive medical services and social support at a Summit ElderCare site while they keep the independence of living in their own homes and communities.
Brief summary of purpose:
Serves as the program liaison for departments across the organization providing direct and indirect program support including, Network Development and Management (contracting and provider relations), Accounting, Medical Economics, Communications, and other related ancillary departments in Fallon Health. The Program Manager produces related reports both routine and ad hoc to support program operations and continuous improvement.
The Program Manager leads critical program-level strategically important initiatives such as those related to program expansion and CMS audit preparations, for example, and assists the Executive Director in overseeing and managing Summit ElderCare operational and regulatory functions in support of the Leadership teams. This role serves as a member of the Summit ElderCare Leadership Team, the Summit ElderCare Quality and Utilization Management Team, and other committees and workgroups as assigned.
Education: Bachelor’s degree in health care administration, business administration or related field; Master’s degree preferred.
Experience: A minimum of 5 years of experience in health care, elder services, business administration or related field. Knowledge of regulatory requirements for health insurance industry, excellent written and oral communication skills, excellent organizational and analytical skills, strong problem-solving skills and conflict resolution skills. Knowledge of PACE regulatory requirements a plus