Vice President of Participant Experience

Job description

Join BoldAge PACE and Make a Difference!
Why work with us?
• A People First Environment: We make what is important to those we serve important to us.
• Make an Impact: Enhance the quality of life for seniors.
• Professional Growth : Access to training and career development.

Competitive Compensation
• Medical/Dental
• Generous PTO
• 401K with Match*
• Life Insurance
• Tuition Reimbursement
• Flexible Spending Account
• Employee Assistance Program

BE PART OF OUR MISSION!
Are you passionate about helping older adults live meaningful, independent lives at home with grace and dignity? BoldAge PACE is an all-inclusive program of care, personalized to meet the individual health and well-being needs of our participants. Our approach is simple: We listen to our participants and their caregivers to truly understand their needs and desires.
Vice President of Patient Experience
JOB SUMMARY: The Vice President of Participant Experience leads BoldAge PACE's participant-facing service lines including but not limited to, Social Work, Home Health, Participant Financial Benefits and Resource Utilization, Dietary, Physical Therapy and Occupational Therapy, Art and Music Therapy and Psychotherapy. This includes key areas of national utilization oversight including POLST, Housing, Spend Card and Self-Pay/Spend-Down with a hands-on, detail-level approach. Reporting to the Chief Clinical Officer, this role drives measurable improvement in the day-to-day care participants receive. The role also carries matrixed clinical leadership for Social Work, Home Health, and care planning, setting clinical direction in conjunction with BoldAge Leadership.
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.

EXPERIENCE AND EDUCATION:
• 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.