Vice President of Skilled Nursing Operations

Care Initiatives is seeking a Vice President of Skilled Nursing Operations to join our 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 our own internal staffing agency. We 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. What You’ll Do & Key Responsibilities: Strategic & Governance Leadership 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. Operational Excellence & Standardization 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. Clinical Integration & Quality Outcomes 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. Regulatory Compliance & Risk Oversight 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. Financial Performance & Stewardship 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. Leadership, Talent Development & Culture 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. Growth Readiness & Portfolio Advancement Ensure operational readiness for organizational growth, transitions, and strategic initiatives. Collaborate on due diligence and operational feas…