Acara is a San Antonio-based, PE backed and one of the largest providers of quality in-home health care in the state of Texas serving Central and South Texas across nine branch locations. We provide Home Health, Hospice, Personal Home Care, and CLASS services to thousands of Texas, and we take seriously our responsibility to deliver that care with integrity, compliance and compassion.
Acara is seeking an Associate VP, Clinical Operations to provide operational leadership across Acara’s Home Health and Hospice service lines, with direct oversight of the Director of Home Health and Director of Hospice. This role owns program-level performance including operational execution, regulatory compliance, and P&L results for both service lines across all applicable branch locations.
Key Responsibilities
Operational Leadership
Provide direct operational oversight to the Home Health and Hospice service lines across all applicable Acara branch locations.
Directly supervise the Director of Home Health and the Director of Hospice; set performance expectations, coach leadership development, and ensure consistent execution of operational and clinical-operations standards across both programs.
Own program-level P&L for Home Health and Hospice, including budget development, cost and labor management, productivity, and performance against financial targets.
Travel regularly among branch locations to support Directors, conduct operational and compliance site visits, and maintain consistency across markets.
Licensed Administrator Responsibilities
Serve as the Licensed Administrator or Alternate Administrator of record for substantially all Acara licenses tied to a clinical service line (Home Health and Hospice), excluding licenses that do not carry an associated clinical service line.
Maintain administrator qualifications and required training hours under 26 TAC §§558.244 and 558.259, and fulfill all administrator responsibilities defined under applicable HCSSA licensing standards.
Serve as the primary point of contact for state licensing surveys, Medicare/Medicaid certification surveys, and other regulatory inspections affecting Home Health and Hospice licenses.
Compliance & Regulatory Oversight
Ensure ongoing compliance with the Medicare Conditions of Participation for Home Health Agencies (42 CFR Part 484) and Hospice (42 CFR Part 418), Texas Health and Safety Code Chapter 142, and 26 TAC Chapter 558.
Oversee agency-wide adherence to survey readiness, plans of correction, and deficiency remediation for Home Health and Hospice locations.
Ensure Home Health and Hospice programs maintain active QAPI (Quality Assessment and Performance Improvement) participation, infection prevention and control practices, and emergency preparedness plans consistent with federal and state requirements.
Partner with Compliance, Human Resources, and executive leadership on policy development, licensing changes, and risk mitigation affecting clinical operations.
Cross-Functional & Strategic Collaboration
Partner with Sales leadership to align referral growth, market development, and census strategy with Home Health and Hospice operational capacity.
Collaborate with the AVP, Personal Home Care, and other Acara service line leaders to support coordinated continuum-of-care initiatives across service lines.
Report to the Chief Operating Officer on service line performance, compliance status, staffing, and strategic initiatives.
Participate in leadership planning related to succession, growth markets, and organizational structure for Home Health and Hospice.
Qualifications
Education and Licensure
Bachelor's degree in healthcare administration, business administration, nursing, or a related field required; Master's degree preferred. Equivalent progressive leadership experience in Home Health and/or Hospice operations may be considered in lieu of degree.
Must meet Administrator/Alternate Administrator qualification requirements under 26 Texas Administrative Code §558.244 for Acara's Home and Community Support Services Agency (HCSSA) licenses and complete the initial and first-year administrator training required under 26 TAC §558.259. Or be willing to complete them within 30 days of hire.
Where the role serves as Administrator for a Medicare-certified Home Health Agency, must meet the personnel qualifications for Administrator under 42 CFR §484.115(a); where serving as Administrator for a Medicare-certified hospice, must meet the qualifications established by Acara's hospice governing body consistent with 42 CFR §418.100(d).
Current, unencumbered Texas clinical license (RN, LVN, or applicable therapy/clinical license) is not required but is viewed favorably, particularly for candidates with prior service as a Home Health and/or Hospice Administrator or Executive Director.
Experience
Five or more years of progressive operational leadership experience in Home Health and/or Hospice, including direct oversight of branch or program-level operations.
Strong preference for candidates with leadership experience across both Home Health and Hospice; candidates with deep, demonstrated operational strength in one service line and a willingness to grow into the other will also be considered.
Prior service as a Home Health and/or Hospice Administrator or Executive Director strongly preferred.
Demonstrated experience owning program-level P&L, including budgeting, labor and productivity management, and performance against financial targets.
Experience leading multi-branch or multi-site operations, including managing through Directors or other branch-level leadership, strongly preferred.
Working knowledge of Medicare Conditions of Participation for Home Health (42 CFR Part 484) and Hospice (42 CFR Part 418), Texas Health and Safety Code Chapter 142, and 26 TAC Chapter 558 HCSSA licensing standards.
Knowledge, Skills and Abilities
Strong operational and business acumen, including proven P&L ownership and multi-site leadership.
Working knowledge of Home Health and Hospice Medicare Conditions of Participation and Texas HCSSA regulatory requirements.
Demonstrated ability to lead through Directors and other branch-level leaders across geographically dispersed locations.
Strong compliance and regulatory judgment, with the ability to serve effectively as a Licensed Administrator across multiple agency locations.
Excellent relationship-building skills across clinical, sales, compliance, and executive functions.
Clinical background is not required and is treated as a plus rather than a prerequisite; the priority is demonstrated operational leadership strength.
Physical Demands & Working Conditions
Office-based leadership role with regular travel, including overnight travel, by personal automobile to branch locations including Austin, Del Rio, Eagle Pass, and Laredo to support branch operations, regulatory surveys, and leadership meetings.
Valid Texas driver's license, reliable transportation, and current automobile liability insurance required.
Pay: $155,000.00 - $165,000.00 per year
Benefits:
- Dental insurance
- Employee assistance program
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
