Fallon Health

  • Operations Manager - Summit Eldercare PACE Program !

    Location US-MA-Worcester
    Posted Date 2 weeks ago(4/9/2018 12:46 PM)
    Job ID
    # Positions
  • Overview


    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.



    The Manager of SE Operations assists the Summit ElderCare Senior Director of Operations to manage the program level operational and regulatory functions related to home care responsibilities. Provides guidance and instruction and monitors the daily work productivity and performance of the Summit ElderCare Service Coordination Unit to ensure operational business needs are met and adherence to established policies and procedures. This role is responsible for the recruitment, interviewing, hiring, and performance management of the Service Coordination Unit employees. Works under the guidance and supervision of the Senior Director and, as needed, escalates concerns to address resource constraints, interpret policies, establish new processes, propose process change and resolve conflict. Responsible for utilizing the Verint application to monitor SCU call quality, provide feedback to Service Coordinators and generate reports related to call quality and productivity. Acts as a resource to the Summit ElderCare sites and participates in various program-wide projects, initiatives and other tasks as assigned by the Senior Director of Operations.


    Provides day-to-day oversight of the Summit ElderCare Service Coordination Unit

    • Manages the daily workload, current assignments of team members, and required adjustments (of staff and assignments) to meet business needs.
    • Ensures the team has appropriate resources and highlights areas of need to manager for resolution.
    • Raises concerns to the Senior Director regarding issues that may affect the work environment, team or individual performance. Participates in implementing solutions as appropriate.
    • Monitors call quality and volume; provides constructive feedback to Service Coordinators as warranted.
    • Conducts periodic audits of SCU documentation to ensure standards are met.
    • Provides orientation for all new Service Coordinators and ongoing training to the team.
    • Home Care Agency related tasks
    • Onboards new Home Care agencies to meet the demand of home care needs.
    • Meets regularly with the Home Care agencies to discuss the partnership and escalated issues.
    • Reviews all invoices related to home care to ensure that the services were authorized.
    • Serves as the point of contact for all home care escalated issues.
    • Other Operation Responsibilities
    • Acts as a resource to and supports Senior Director in various program-wide projects and initiatives as needed and assigned.
    • Works with IT Business Partner, Application Support Specialists and others to build reports and collect data as it relates to SE home care services.
    • Provides data and reporting support as needed to the Quality & Risk Management Department.


    • High school diploma required. Associate’s or Bachelor’s degree preferred.
    • Minimum of 2 year supervisory experience
    • 3-5 years’ experience in health care or insurance setting preferred
    • Strong background in customer service and advanced computer skills required
    • Proficiency in Microsoft Office products required; experience with NextGen, SQL, QNXT, and Verint highly desirable.
    • Excellent written and verbal communication skills
    • Ability to establish effective working relationships with direct reports, peers, and leaders.
    • Ability to work independently and exercise sound judgment
    • Ability to establish effective records-keeping systems and prepare clear and concise reports
    • Comfortable delivering constructive feedback to direct reports on performance and productivity
    • Comfortable administering disciplinary action when warranted up to and including employee termination

    Comfortable interacting with individuals at all levels of FH.


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