Hospice Services Manager

Job Description

Job Description

Summary

The Manager of Hospice Services is responsible for the operational oversight, performance management, and strategic execution of the ACO’s hospice programs across MSSP, High Needs/REACH populations. This role ensures optimal hospice utilization, cost performance, and quality outcomes while maintaining strong vendor relationships and driving provider education and engagement. The Manager serves as the central leader for hospice program operations, partial oversight of one direct report responsible for task-level execution, while partnering closely with Analytics/Data, Clinical Leadership, and Network Development to drive measurable improvements in end-of-life care. This role reports to the VP of Network Operations, who provides strategic direction, scalability planning, and executive oversight of hospice initiatives.

Key Responsibilities

Hospice Program Operations & Oversight

• Own day-to-day operations of all hospice programs across ACO lines of business (MSSP, High Needs/REACH)
• Oversee and manage one FTE responsible for hospice administrative execution, ensuring accuracy, timeliness, and accountability
• Establish workflows, SOPs, and operational standards to support scalable hospice program management
• Ensure alignment of hospice operations with value-based care objectives, cost containment, and quality performance

Hospice Performance Management & Analytics

• Monitor and manage hospice KPIs including:
  • PMPM/PMPY cost trends
  • Length of stay (long and short LOS)
  • End-of-life acute care utilization
  • Hospice penetration and alignment rates
• Oversee PEEP portal/related workflow utilization and ensure ≥70% compliance across preferred vendors
• Track and manage ClosedLoop (CL) predictive score alignment, including referral risk alignment and CMO review thresholds
• Identify trends, gaps, and opportunities; lead corrective action plans with internal teams and hospice vendors
• Partner with Analytics teams to translate data into actionable performance strategies

Hospice Vendor Relationship Management

• Serve as primary operational leader for preferred hospice vendor relationships
• Maintain accountability structures with vendors including:
  • Performance reviews
  • Data sharing and reporting expectations
  • Clinical documentation support for long LOS reviews
• Lead regular vendor meetings to review performance, address issues, and drive continuous improvement
• Support network development efforts by evaluating and onboarding high-performing hospice partners and monitoring to appropriate hospice benefit utilization

Third-Party Program Management

• Oversee integration and operational execution of ClosedLoop predictive analytics within hospice workflows
• Ensure alignment between referral patterns and predictive risk scores (>90% target)
• Manage long LOS (180+ day) review workflows in partnership with clinical leadership and vendors
• Drive adoption of predictive insights into operational and clinical decision-making

Hospice & Palliative Care Education

• Develop and deliver provider-facing education on:
  • Hospice eligibility and appropriate utilization
  • Palliative vs hospice care pathways
  • Advance Care Planning (ACP) strategies and billing
• Create scalable educational materials (1-pagers, presentations, toolkits) for PCPs and specialists
• Partner with internal teams to expand education efforts across all ACO programs
• Support enterprise-wide initiatives to improve earlier hospice alignment and ACP engagement

Utilization Management & Claims Integrity

• Oversee monitoring of hospice-related claims including:
  • Overlap claims
  • Billing discrepancies
  • Part A/Part B utilization conflicts
• Collaborate with internal teams and vendors to resolve issues and reduce leakage/waste
• Ensure compliance with CMS regulations and internal policies

Cross-Functional Leadership & Communication

• Provide regular performance updates and insights to executive leadership
• Collaborate with:
  • Analytics/Data (data insights and reporting)
  • Clinical leadership (care model alignment)
  • Performance (cost and savings tracking)
• Translate complex data into clear operational strategies and executive-ready summaries

Supervisory Responsibilities

• Partial oversight of one FTE responsible for hospice program administration and task execution
• Provide coaching, performance management, and accountability for deliverables
• Ensure high reliability in execution of hospice workflows and reporting

Education & Experience

• Bachelor’s degree required; clinical degree (RN, NP) preferred
• 5+ years of experience in hospice, palliative care, population health, or value-based care
• Experience in ACO or risk-based models strongly preferred
• Familiarity with Medicare programs and data preferred
• Demonstrated experience managing programs and/or people

Skills & Competencies

• Deep understanding of hospice operations, Medicare benefit structure, and utilization drivers
• Strong analytical and performance management capabilities
• Excellent relationship management and communication skills
• Ability to translate data into actionable strategies
• High level of ownership, accountability, and operational rigor