Licensed Administrator & Director of Strategic Relationships

Ashley House NW – Shoreline, WA (On-Site)

Bridges to Home, part of Ashley House, is seeking a Licensed Pediatric SNF Administrator to lead Washington State’s first and only pediatric skilled nursing facility dedicated to helping medically fragile and medically complex children transition safely from hospital to home. This is a unique opportunity to combine operational leadership with mission-driven work in a highly specialized pediatric setting that makes a direct and lasting impact on children and families across the region.

This leadership role oversees facility operations, interdisciplinary collaboration, regulatory compliance, and strategic relationship development with hospital partners, referral sources, and managed care organizations. The Administrator will work closely with executive and clinical leadership to support high-quality patient care, strengthen community and payer partnerships, and help guide the continued growth and long-term success of Bridges to Home.

Please review the full job description for extensive information regarding this opportunity.

What You’ll Do

Licensed Administrator duties

1.      Provides overall leadership and management of the 12‑bed pediatric skilled nursing facility, ensuring high‑quality, family‑centered care for medically fragile and complex children;

2.      Directly supervises designated facility staff at the Shoreline location, including MDS Nurse, Dietary Services, Office Administrator, Activities Coordinator, and Environmental Services. Collaborates with the Associate Executive Director of Clinical Services in working with the Director of Nursing Services to support effective clinical operations and nursing leadership, and coordinates with the Maintenance Manager to support efficient day-to-day facility operations. Ensure effective performance management, coaching, and staff development across designated facility staff;

3.      Partners closely with Human Resources, Program Services, and Accounting to ensure coordinated interdisciplinary services and alignment with Ashley House policies and strategic priorities;

4.      Leads and monitors facility operations to ensure compliance with clinical order sets and all applicable federal, state, and local regulations, licensing standards, and payer requirements;

5.      Performs budget development and management;

a.      Leads the annual facility budget development process in collaboration with Executive Leadership and Accounting, incorporating census projections, staffing models, and programmatic priorities;

b.      Monitors financial performance against budget throughout the year, including revenue, expenses, and key operating ratios, and recommends/implements corrective actions when variances occur;

c.      Uses financial data to guide staffing plans, purchasing decisions, and operational changes that support both financial sustainability and high‑quality care;

d.      Prepares routine financial and operational dashboards for review with the Executive Director and other leaders, highlighting trends, risks, and opportunities.

6.      Oversees development, implementation, and ongoing review of facility policies and procedures, ensuring staff understanding and adherence;

7.      Ensures timely and accurate reporting of program, quality, and compliance metrics to the Executive Director and other stakeholders;

8.      Supports and promotes a culture of safety, continuous quality improvement, and interprofessional collaboration in the facility;

9.      Serves as a key liaison with clinical leaders, including the physician providing medical direction, to ensure effective coordination of care;

10.   Participates in and lead strategic planning at the facility level, aligning operational goals with agency‑wide strategic and business development priorities.

Director of Strategic Partnerships

  1. Carrys out all business development and external relations activities in a manner consistent with the Administrator’s required on-site presence and active administrative charge of the skilled nursing facility, ensuring that licensed administrator duties remain the core responsibility of the role;

  2. Collaborates with the Executive Director as a strategic thought partner in evaluating organizational direction, identifying unmet needs in the pediatric post-acute care system, and developing partnership, service, and contract strategies that align with Ashley House’s mission, regulatory requirements, and long-term sustainability;

  3. Develops and executes a strategic business development plan to increase appropriate referrals and census from regional hospitals, especially Seattle Children’s Hospital and other pediatric acute‑care partners;

  4. Proactively builds, strengthens, and sustains relationships with hospital case management, physician providers, discharge planners, and other referral sources to position Bridges to Home as the preferred pediatric transitional care option;

  5. Identifies, pursues, and supports negotiation of contracts and single case agreements with managed care organizations (MCOs), commercial payers, and other funders in coordination with the Executive Director, Director of Business Development, and Accounting;

  6. Tracks and analyzes referral patterns, payer mix, and occupancy trends; uses data to inform outreach strategies, contract priorities, and service positioning;

  7. Represents Ashley House and Bridges to Home at meetings, presentations, and networking events with hospital partners, MCOs, community organizations, and other stakeholders;

  8. Collaborates with internal leaders on marketing and communication efforts that support external visibility, including informational materials, presentations, and site visits/tours for referral sources and payers;

  9. Maintains updated knowledge of MCO policies, authorization processes, and reimbursement structures relevant to pediatric skilled nursing and transitional care; shares key changes with leadership and billing teams;

  10. Works closely with Program Services and Accounting to ensure that contracts and single case agreements are operationalized, monitored for performance, and renewed or adjusted as needed;

11.   Serves as a problem‑solver and escalation contact for hospital partners and payers when complex placement, authorization, or care coordination issues arise, ensuring timely resolution and strong partner satisfaction.

LEADERSHIP RESPONSIBILITIES

Performance Management:

  1. Provides on-site supervision to mid-management, supervisory, and some support staff;

  2. Interviews and makes hiring decisions to fill direct report positions;

  3. Ensures proper supervision is afforded to all program staff (approximately 40);

  4. Ensures orientation and training is provided to all staff in compliance with agency guidelines, licensing requirements, and best practice;

  5. Provides for a supportive environment that is conducive for all staff to perform at their best;

  6. Addresses performance and competence issues as needed within the guidelines established by the Human Resources Department, and with proper documentation;

  7. Ensures staff adherence to established protocols and best practices;

  8. Promotes and facilitates staff growth and development;

  9. Ensures the requirements of the collective bargaining agreement are followed;

  10. Participates in contract negotiations as directed.

Asset & Supply Management:

  1. Ensures the facility and vehicles are properly maintained, safe, clean, and aesthetically pleasing, in partnership with the Maintenance Department;

  2. Ensures adequate supplies are on hand to enable full operation;

  3. Establishes and maintains proper and efficient storage of supplies and equipment;

  4. Interfaces with vendors to secure equipment and supplies.

Quality Assurance:

  1. Coordinates the development and maintenance of policies, procedures, and protocols that guide operations;

  2. Participates in the development of, and oversees a Continuous Quality Assurance Program that minimizes risk and provides the best possible care based in best practice;

  3. Solicits stakeholder feedback to ensure satisfaction and to proactively address potential issues;

  4. Ensures patient care plans are developed according to stated guidelines and ensures they are implemented as written;

  5. Ensures staff competence;

  6. Performs individual chart audits to ensure compliance with regulations and quality of care on a bi-monthly or more frequent basis;

  7. Reviews incident reports, providing required reporting;

  8. Ensures discharge planning is comprehensive and initiated as soon as possible, before or just after admission;

  9. Ensures aftercare is provided according to program design in collaboration with Program Services.

Medical Care:

  1. Ensures the health and safety of the individual is top priority;

  2. Works with the Medical Director to ensure proper protocols are established, updated, and maintained;

  3. Seeks consultation from Medical Director as needed regarding patient care;

  4. Interfaces and partners with hospital doctors and clinics to ensure communication regarding care and transition are optimal;

Electronic Record Keeping:

  1. Completes or oversees the completion of MDS & PBJ reporting to the Centers for Medicare Services; 

  2. Oversees the implementation and on-going use of electronic health records;

  3. Works with hospital staff to ensure ease of interface between the two health record systems;

  4. Coordinates the use of tele-medicine;

  5. Ensures staff are trained in the use of the EMR and telemedicine programs;

  6. Ensures software and hardware needs are addressed.

Communication:

  1. Provides verbal and written reports to the Chief Executive as directed;

  2. Uses electronic, verbal, and written communication effectively to fulfill job responsibilities.

Other:

  1. Participates as a member of the agency leadership teams;

  2. Participates as a member of ad hoc committees and work groups;

  3. Works with other agency leaders on ongoing program enhancement and development;

  4. Maintains credentials, certifications, vaccinations, and seeks continued professional development;

  5. Other duties as assigned or needed.

  6. Maintains ability to pass ongoing driving and criminal background checks required under State licensing and program requirements;

  7. Drives personal and agency vehicles to efficiently execute job responsibilities;

  8. Attends and participates in meetings and committees as needed;

  9. Performs other duties as assigned or directed.

MINIMUM REQUIREMENTS:

 1.     At least 21 years of age;

2.     Possesses either:

a.     A valid Washington State Nursing Home Administrator Licensure or a valid equivalent licensure from another State, by which a Washington State licensure may be obtained.

OR

b.     A baccalaureate or graduate degree that is accredited by either CHEA or USDOE AND meets one or more of the AIT exemption requirements below to allow for immediate application for the NAB nursing home administrator examination:

                                                    i.          Five years’ extensive supervisory and budgetary responsibility (within the last 7-years) in one of the following positions: Hospital Administrator; Assistant Administrator in a hospital or state licensed nursing home; Director of a hospital based skilled nursing facility; Director of a sub-acute /transitional care unit; Regional Director of Rehabilitation Services in a skilled nursing facility; or equivalent military experience to one of these civilian classifications;

                                                   ii.          Experience as a licensed Nursing Home Administrator for a minimum of two years in the past five years;

                                                 iii.          A baccalaureate or graduate degree in Long-Term Care Administration from a program accredited by NAB;

                                                 iv.          Has been issued an HSE designation from NAB;

                                                   v.          A graduate from a degree program in a recognized educational institution that included a one thousand hour practical experience (practicum) in a nursing home. (This practical experience must have been structured to allow the student a majority of time in a systematic rotation through each department of a resident-occupied nursing home. The practical experience must have included planned readings, writing, and project assignments. The practical experience must have included regular contact with the administrator of the facility in which the practical experience was completed.)

3.      A solid proficiency in the English language with professional communication skills including interpersonal, verbal, non-verbal, and written communications with the ability to write professional policies and read, analyze, and interpret common scientific and technical journals, clinical documents, regulations, WAC’s, medications, and physician orders, and effectively present information to senior leadership and employees. Bilingual abilities are preferred;

4.      Working knowledge of Microsoft Office programs - Office 365, Outlook, Microsoft Word and Excel preferred;

5.      Ability to pass and maintain an acceptable criminal background check with the State of Washington, including personal references, and an FBI fingerprint criminal history check;

6.      Proof of an acceptable driving record through the provision of a driving abstract on annual basis or as requested;

7.      A current Washington State driver’s license or valid driver’s license as an active duty armed forces personnel or dependent of an active duty armed forces personnel and the ability to be insured to drive agency vehicles;

8.      Proof of vehicle insurance;

9.      Proof of a valid Tdap, Flu, and COVID-19 immunizations;

10.   Proof of valid Tuberculosis (TB) testing, including 1- or 2-step skin test, blood test, and/or chest x-ray;

11.   Proof of a valid Healthcare Provider (BLS) CPR certification;

12.   Proof of a valid Food Handler’s Permit from the Washington State Department of Health;

13.   Demonstrated constant professionalism, critical thinking, and objectivity;

14.   The ability to make independent decisions and render judgement when circumstances warrant such action;

15.   Ability to meet the physical demands of the job as defined within this job description.

WHAT WE CAN OFFER YOU:

This full-time position offers an annual salaried compensation range of $139,140 – $187,314, with placement dependent on relevant professional experience. It comes with a full compensation package including Med., Dent., Vis., Life, Dis., HRA., Matching 403b7, Paid Time Off, and Paid Holidays.

Ashley House recognizes being a part of the medical community, we have responsibilities to advocate and provide the best care by overcoming existing historic, institutional, and systematic barriers. We are committed to advancing equity and fostering a diverse and inclusive community, organization, and culture.

Qualified and interested? Apply now if you want to be considered for joining our mission and values driven team. More than a job - We change lives!

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Alex Ekstrom