Director, LTSS Clinical Care Management

Centene
Indiana
Workplace: RemoteFull timeUSD 127,300 - 236,100 annuallyFunction: Executive & General ManagementExperience: 7+ yearsSkills: ["Leadership","Strategic planning","Process improvement","Coaching","Compliance management"]

Serve as the LTSS subject matter expert and lead long-term care management for members with physical/medical and/or behavioral/mental health needs. Direct the development, implementation, monitoring, and continuous improvement of long-term care management processes, policies, and metrics to deliver high-quality, cost-effective outcomes. Oversee staff caseloads, vendor oversight, contract-required reporting, and audits, and lead process improvements and departmental strategy including onboarding, hiring, and training.

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FursaFursa
Centene
Centene
2 months ago

Director, LTSS Clinical Care Management

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Last checked: 24 days agoStatus: Live

Job Summary

Serve as the LTSS subject matter expert and lead long-term care management for members with physical/medical and/or behavioral/mental health needs. Direct the development, implementation, monitoring, and continuous improvement of long-term care management processes, policies, and metrics to deliver high-quality, cost-effective outcomes. Oversee staff caseloads, vendor oversight, contract-required reporting, and audits, and lead process improvements and departmental strategy including onboarding, hiring, and training.
Location: Indiana
Workplace: Remote
Employment Type: Full time
Job Function: Executive & General Management
Seniority: Director level

Key Responsibilities

  • •Provide leadership for the development, implementation, monitoring, and ongoing improvement of the long-term care management process.
  • •Set goals and objectives for the long-term care management team and oversee care management data and reporting metrics with senior leadership.
  • •Lead long-term care management policies and procedures to ensure compliance with corporate, state, and NCQA standards.
  • •Oversee and monitor work assignments and caseloads of long-term care management staff based on state requirements and member needs.
  • •Direct and evaluate departmental operations, including the long-term care management model, staffing, onboarding, and staff competencies; also lead process improvements and special projects.

Pay and Benefits

Salary: USD 127,300 - 236,100 annually
Perks:Health Insurance401kPaid LeaveEquity

Key Requirements

  • •Positions overseeing RN team members: Graduate from an accredited school of nursing or a Bachelor’s degree and 7+ years of related experience, including prior management experience.
  • •Positions overseeing BH team members: Master’s degree or Graduate from an accredited school of nursing and 7+ years of related experience, including prior management experience.
  • •4+ years management experience preferred.
  • •Expert knowledge of industry regulations, policies, and standards preferred, including compliance with NCQA standards.
  • •Current state’s Registered Nurse (RN) license required (or Licensed Clinical Behavioral Health Professional based on state requirements, e.g., LCSW, LMSW, LMFT, LMHC).
Experience:7+ years
Skills:LeadershipStrategic planningProcess improvementCoachingCompliance management
Licenses:Registered Nurse (RN) licenseLCSWLMSWLMFTLMHC

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn