Senior Director, LTSS Clinical Care Management
Core
Leads and directs long-term care management for members with physical/medical and behavioral/mental health needs to develop high-quality, cost-effective healthcare outcomes.
Role type
Senior Director, Clinical Care Management
Builds
Long-term service programs and care management strategies
Domain
Healthcare / Long-term services and supports (LTSS)
Required skills
Long-term care management, strategic planning, vendor oversight, policy enforcement, data analysis, budget forecasting, team leadership, process improvement
Preferred skills
Nursing background (RN), behavioral health expertise, managed care principles, clinical assessment, regulatory knowledge, project management
Technologies
NCQA standards, state/federal regulations, care management software
Responsibilities
Develop and assess high-quality, cost-effective healthcare outcomes; lead RFP development and submissions; oversee long-term care management staff and caseloads; enforce policies and procedures; monitor member data and trends; coordinate large projects; provide coaching and guidance to the team.
Seniority
Senior Director, strategic leadership & operational oversight