Vice President of Skilled Nursing Operations

Care Initiatives • West Des Moines, IA

4d

About The Position

Care Initiatives is seeking a Vice President of Skilled Nursing Operations to join their team. As the largest single operator of quality nursing homes in Iowa, Care Initiatives has over forty (40) skilled nursing communities, eight (8) hospice offices (and growing!), plus their own internal staffing agency. They are committed to providing exceptional care and support at every stage of the healthcare journey. The Vice President of Skilled Nursing Operations leads the performance of the skilled nursing portfolio through system-level strategy, operational discipline, and leadership accountability. This role translates organizational priorities into clear operational expectations, ensures consistent execution across facilities, and partners with executive and corporate leaders to achieve Care Initiatives’ mission, values, and strategic objectives.

Requirements

• Bachelor’s degree required
• Nursing Home Administrator (LNHA/NHA) license required.
• Minimum of 5 years of senior executive leadership experience in skilled nursing and/or long-term care operations with multi-site responsibility required.
• Demonstrated success improving quality outcomes, regulatory performance, and financial results.
• Proven ability to lead leaders, drive enterprise change, and sustain operational discipline.
• Demonstrated results driving enterprise-wide census growth.
• Comprehensive knowledge of federal and state skilled nursing regulations.
• Strong understanding of skilled nursing operational drivers including staffing, census, payer mix, and financial performance.
• Working knowledge of performance improvement methodologies and data-driven management.

Nice To Haves

• Master’s degree preferred (MHA, MBA, or equivalent).

Responsibilities

• Establish the strategic direction for skilled nursing operations in alignment with organizational goals, growth plans, and clinical strategy.
• Develop and maintain system-wide operational frameworks, performance standards, and governance structures.
• Provide executive oversight and counsel to the COO regarding operational risk, performance trends, and portfolio-wide opportunities.
• Ensure consistent leadership cadence, accountability structures, and decision-making discipline across the skilled nursing platform.
• Set, implement, and monitor standardized operating models, best practices, and management systems across all skilled nursing facilities.
• Reduce unwarranted variation by driving consistency in operations, service delivery, and administrative practices.
• Lead and sponsor enterprise operational improvement initiatives focused on reliability, efficiency, and resident experience.
• Ensure timely identification, escalation, and resolution of operational risks and performance issues.
• Align operational execution with clinical quality priorities and resident outcome goals.
• Reinforce a culture of quality, safety, resident-centered care, and continuous improvement.
• Ensure operational support and accountability mechanisms are in place to sustain quality improvement initiatives.
• Monitor performance trends and deploy targeted interventions for underperforming facilities.
• Provide executive oversight for regulatory readiness and sustained compliance with federal, state, and local requirements.
• Ensure consistent survey preparedness systems, corrective action discipline, and long-term compliance sustainability.
• Partner with Compliance, Legal, and Risk leaders to identify, manage, and mitigate operational and regulatory risk.
• Maintain awareness and oversight of high-risk events with potential resident safety, compliance, or reputational impact.
• Own operational accountability for portfolio-level financial performance in collaboration with Finance.
• Drive effective labor management, productivity standards, expense control, and resource utilization.
• Lead operational action planning for budget variances and underperforming metrics.
• Support census growth, payer mix optimization, and margin sustainability through operational levers.
• Lead, develop, and hold accountable SNF operational leaders including administrators in training.
• Strengthen facility administrator performance through coaching, expectations clarity, and development pathways.
• Partner with Human Resources on leadership development, performance management, succession planning, and workforce strategy.
• Model Care Initiatives’ values and reinforce a culture of accountability, engagement, and service excellence.
• Ensure operational readiness for organizational growth, transitions, and strategic initiatives.
• Collaborate on due diligence and operational feasibility for growth opportunities.
• Align admissions, customer service, and operational processes to support census stability and growth.
• Build effective partnerships with corporate leaders, facility leaders, and key stakeholders.
• Communicate operational priorities, expectations, and performance results clearly and consistently.
• Represent skilled nursing operations in executive discussions and enterprise initiatives.

Benefits

• Unlimited vacation time.
• Robust benefit options including medical, dental, vision, retirement savings, Basic Life and AD&D, Voluntary Life AD&D, Short-Term and Long-Term Disability.
• On-demand pay

What This Job Offers

• Job Type: Full-time
• Career Level: Executive