Director, LTSS Clinical Care Management
Core
Directs long-term care management for members with physical/medical and behavioral/mental health needs to develop cost-effective healthcare outcomes.
Role type
Director, LTSS Clinical Care Management
Builds
Long-term care management programs, strategies, and processes
Domain
Healthcare / Long-term Services and Supports (LTSS)
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Strategic planning, team leadership, budget development, regulatory compliance, data analysis, vendor oversight, process improvement, stakeholder management
Preferred skills
Clinical care pathway development, care plan creation, medication knowledge, managed care principles, provider collaboration
Technologies
Information technologies for care management
Responsibilities
Lead RFP development and submissions for LTSS programs; oversee care management data and reporting metrics; ensure compliance with NCQA and state/federal standards; manage staff caseloads and work assignments; develop department budgets; coordinate large-scale projects; evaluate departmental operations and staffing; review member data to identify trends and improve quality; develop onboarding and training strategies for new team members
Seniority
Director, strategic leadership & operational oversight
