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RN Director, MLTSS Program Care Services

DIRECTOR, MLTSS Program Care Services (Medicaid Management Long Term Services and Support)

Optima Health is seeking a multi-faceted, experienced RN leader with extensive experience in dealing with Medicaid population with expertise in care coordination and providing a full range of services to this community. The RN Director- MLTSS will be talented with people management and interacting with multiple interdisciplinary individuals and have an out the box thinking approach to the role. The Director will have a desire and capability to strategize and build a team of over 500 individuals with the likewise passion for healthy, comprehensive and satisfactory long term living lifestyle for the aging population. This position requires about 25% travel within the state of Virginia only.

*Job Summary
The Director, MLTSS Program Care Services is the clinical and LTSS subject matter expert, is the key leader for service delivery and oversight on the program executive team, and will be the primary services liaison with DMAS (Virginia’s Medicaid Agency). 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.

Required Education
Bachelor’s degree in Nursing required.
Master’s degree in Business Administration, Health Administration or Nursing required.

Licenses and Certifications
Required: Registered Nurse

*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 system.
*Must 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 populations.
*Proven ability to drive clinical teams toward a culture of compliance, strategic and organizational agility, and mastery of engaging and developing staff.

Relocation is covered fully for candidate and their family and we are willing to pay temporary housing while in transition to the Hampton Roads, VA area. This is an exciting opportunity for a high caliber individual who would love the opportunity to build a program from the ground up at Optima Health.

Time:  Full time
Salary:  Salary
Category:  Operations

Updated: 12/7/2016 1:56:45 PM

Job Contact:
Richelle Demps

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4417 Corporation Ln
Virginia Beach, VA 23462