Director, Care Management - LTSS

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

Direct and improve long-term care management for members, developing strategies and objectives to deliver high-quality, cost-effective outcomes. Lead the care management team through performance management, policies and procedures aligned to corporate/state and NCQA standards, and oversight of reporting, caseloads, and vendor activities. Use member data to identify trends, improve operating performance, and support audits while coordinating projects and coaching staff to enhance member and provider experience.

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FursaFursa
Centene
Centene
1 day ago

Director, Care Management - LTSS

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Last checked: 11 hours agoStatus: Live

Job Summary

Direct and improve long-term care management for members, developing strategies and objectives to deliver high-quality, cost-effective outcomes. Lead the care management team through performance management, policies and procedures aligned to corporate/state and NCQA standards, and oversight of reporting, caseloads, and vendor activities. Use member data to identify trends, improve operating performance, and support audits while coordinating projects and coaching staff to enhance member and provider experience.
Location: Pennsylvania
Workplace: Remote
Employment Type: Full time
Job Function: Executive & General Management
Seniority: Director level

Key Responsibilities

  • •Direct the long-term care of members to develop and assess high-quality, cost-effective healthcare outcomes.
  • •Lead long-term care management and the care management team on performance, improvement, and career growth considerations.
  • •Lead 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, staff experience, and member needs.
  • •Review and monitor long-term care member data to identify trends, improve operating performance and quality care, and participate in internal and external audits as required.
Travel: Medium travel

Pay and Benefits

Salary: USD 127,300 - 236,100 annually
Perks:Health Insurance401kEquityPaid LeaveHolidays

Key Requirements

  • •Requires a Bachelor's degree and 7+ years of related experience, including prior management experience.
  • •Leads long-term care management with experience directing performance and improvement initiatives.
  • •Ensures policies and procedures within long-term care management meet corporate, state, and NCQA standards.
  • •Oversees work assignments and caseloads based on state requirements, staff experience, and member needs.
  • •Monitors and reviews contract-required reporting and participates in internal and external audits as required.
Experience:7+ yearsLong-term careHealthcareCare managementPayersNCQA
Education:Bachelor's
Skills:LeadershipCoachingProcess improvementStrategic planningStakeholder management

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