Director, LTSS and Dual Eligible Program Operations

Job Summary:

The Director, LTSS Program Operations assists the dual eligible President with all open projects and progress towards completion, program enhancements, development, and execution activities related to implementation and ongoing design and standardization for the Dual eligible and LTSS model.

Essential Functions:

• Collaborate with market and senior leadership to formulate and implement business strategies and operational plans to ensure core functionality, scalability, and ongoing department management to support LTSS (HCBS and NH) model
• Primary responsibility for translating business and program vision and strategy into operational tactics - collaborating to build the necessary organizational support and infrastructure
• Establish post implementation strategy and goals to mitigate program risks
• Evaluates operational process effectiveness for accomplishing market goals and objectives; manage operation process improvement activities in collaboration with market teams
• Develop, translate, and execute key strategies for functional/ operational requirements
• Provide leadership and support for product expansion
• Incorporates industry standard, best practice project management tools and techniques in market initiatives
• Recognizes and proactively manages operational dependencies and risks across market operations initiatives portfolio through effective change and risk management controls
• Works closely with leadership to establish, communicate, and perpetuate the corporate vision, ensuring appropriate communication to stakeholders
• Monitors performance across markets LTSSS/HCBS programs to leverage best practice and knowledge sharing for the purpose of improving outcomes through the standardization of evidence-based practices
• Assists the dual eligible President with the monitoring of legislative/governmental activities with the goal of advocating for the full integration LTSS/HCBS standard model, identifying opportunities and issues
• Interacts heavily within Dual Eligible, LTSS program business partners, and builds strong working relationships with all markets
• Engages stakeholders to ensure alignment
• Leads activities ensuring the delivery of high quality, consistent initiatives that result in optimum outcomes for members, providers, and program goals
• Recruits, develops, and leads key staff
• Perform any other job duties as requested

Education and Experience:

• Bachelor's Degree or equivalent years of relevant work experience is required
• Minimum of five (5) years of clinical operations/healthcare administration experience is required
• Minimum of five (5) years of experience driving performance and process improvements, is required in the health care insurance industry
• Experience with Government-regulated (Federal and/or State) health insurance products including Medicaid, Managed Care Waiver, FFS and Medicare is required
• Experience implementing programs with focus on integration is required
• Project management experience required

Competencies, Knowledge, and Skills:

• Able to effectively identify business problems, assess proposed solutions, and understand the needs of business partners and stakeholders
• Ability to communicate effectively with all levels of leadership
• Develops effective working relationships with business partners and stakeholders
• Strong organizational, time management, analysis, and problem-solving skills
• Ability to manage a project from start to finish
• Strong relationship building skills and leadership qualities
• Training and teaching skills/change agent
• Ability to think critically and lead with strategy
• Comprehensive knowledge base crossing all the following areas: Clinical Operations, Market Groups, Business Development, Network, and Operations
• Hands on proficiency in Microsoft Office tools, including Project, Outlook, Word, PowerPoint, and Excel
• Business acumen and politically astute ability to act with diplomacy and sensitivity to cultural diversity

Licensure and Certification:

• Non

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Some travel may be required to fulfill the duties of the role

Compensation Range:
$130,300.00 - $228,100.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Salary

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer, including disability and veteran status. We are committed to a diverse and inclusive work environment.