Director, Nursing Facility Network

ABOUT US 

Join us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market. ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources.

Position Summary

The Director of Nursing Facility Network will be responsible for the following:  strategic development of the ILS Nursing Network; policy implementation; direction of programs / service delivery; financial performance of Nursing Network under risk and other contractual arrangements; support and oversight of other LTC provider related risk arrangements for both Medicaid and Medicare lines of business.

Performs work planning, directing, and coordinating provider network strategies around ILS’ nursing facility network related to both Medicaid and Medicare lines of business. Ensures that goals and objectives are accomplished within prescribed time frame and funding parameters by performing the following duties personally or through assigned staff reporting to the Director.

Essential Functions 

1. Provide oversight of assigned staff in supporting Independent Living System’s network of nursing facilities throughout Florida and in other markets.  
2. Develop short and long-term financial, operational, and branding strategies for ILS, designed to maintain the existing nursing facility network, as well as grow both the network and enrollment within the network.
3. Develop and manage risk-based contracts with the nursing facilities within the network and other identified provider types with a focus on aligning goals / incentives between the ILS and affiliated providers.  Manage all risk-based nursing facility contracts against goals and provide reports to management at least quarterly.
4. Establish and maintain regular joint operating committee (JOC) meetings with all nursing facility and other targeted network providers.
5. Ensure nursing facility providers are educated and compliant with all aspects of state, federal and contract requirements and provide ongoing monitoring of compliance.
6. Conduct annual reviews of existing nursing facility and LTC Risk Contracts.
7. Oversee and assist Provider Network staff in conflict resolution as necessary for problematic contracts.
8. Develop and maintain nursing facility and LTC Risk contracting policies and procedures.
9. Review all nursing facility and LTC risk-based contracts to ensure compliance with State and Federal requirements at least annually.
10. Develop and implement action plans as needed to remediate areas of concern within the nursing facility network.
11. Facilitates problem resolution for complex problems between providers, claims and member relations groups. Provide direction to direct reports to ensure timely issue resolution and escalates to leadership when necessary.
12. Responsible for ensuring that services provided to the frail, elderly and physically disabled are   comprehensive, cost efficient and of high quality.
13. Study and recommend adjustments in organization, staffing, systems and procedures   
14. Performs other duties as required or assigned.

Education Requirements

Master’s Degree in Healthcare Administration, Social Service Administration Management, Administration, Engineering, or Minimum 6 years related work experience, two (2) of which were in a supervisory with administrative capacity; or an equivalent combination of training, education and experience which demonstrates the ability to perform the duties of the position.

Required Skills

1. Ethical Conduct. 
2. Strategic-Critical Thinking. 
3. Leadership.
4. Decision Making. 
5. Financial Management. 
6. Communications Proficiency. 
7. Presentation Skills. 

EEO STATEMENT In compliance with the Drug-Free Workplace Act of 1988, Independent Living Systems has a longstanding commitment to provide a safe, quality-oriented, and productive work environment. Alcohol and drug abuse pose a threat to the health and safety of ILS employees and to the security of the company's equipment and facilities. For these reasons, ILS is committed to the elimination of drug and alcohol use and abuse in the workplace. Independent Living Systems, LLC, and its subsidiaries, including FCC, provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, disability, ancestry, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.