Director, MLTSS Program Care Services

Location
Richmond, VA
Salary
Competitive
Posted
Oct 02, 2020
Closes
Oct 28, 2020
Ref
139504BR
Function
Management
Industry
Healthcare
Hours
Full Time
As the clinical and line of business subject matter expert, is the key leader for service delivery and oversight on the program executive team, and primary services liaison to assigned medical assistance programs. This role is responsible for operational components of the Healthcare Management Program as well as oversight of utilization management functions and the case management program. Will develop and oversee all program operations across all markets with a focus on program development (including outsourced or partner/vendor relationships), program enhancements, managing interdependencies and risks, program status and evaluation, program growth/expansion in both new and existing markets.

Qualifications

Education Level
RN-Bachelor's Level Degree

Experience
None, unless noted in the "Other" section below

License
Required: Registered Nurse

Preferred: None, unless noted in the "Other" section below

Skills
Required:

Preferred: None, unless noted in the "Other" section below

Other
Bachelors degree in Nursing required. Masters degree in Business Administration, Health Administration or Nursing required.

A minimum of 5 years of experience in or with Medicaid, disability related programs and/or Long Term Service & Support required. A minimum of 5 years of experience management within a medium to large sized public sector managed care organization.

Progressive management experience required with proven outcomes in all aspects of business development and financial management in a medical care delivery systemMust possess effective technical skills regarding health plan administration and medical management concepts.

Extensive knowledge of regulatory requirements and policy coverage guidance applicable to Medicaid/Medicare utilization management.

Knowledge and experience with regulations and best practices applicable to care management of vulnerable populationsProven ability to drive clinical teams toward a culture of compliance, strategic and organizational agility, and mastery of engaging and developing staff.

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