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RN Manager, LTSS Program Care Services

MANAGER, 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 Manager- MLTSS will report to the RN Director- MLTSS and will play a key role in hiring and managing up to 500 talented interdisciplinary individuals. This position will require about 25% travel within the state of Virginia.

Job Summary
The Manager, LTSS Program Services is the LTSS program and clinical subject matter expert that is responsible to supervise, direct and evaluate an interdisciplinary clinical team to assure effectiveness of care coordination activities, routinely assessing and monitoring members’ status, needs and progress. This role is responsible for operational components of the MLTSS Program, as well as oversight of utilization management functions and the care coordination program in accordance with contractual agreements. Will develop and oversee all program services and clinical operations across all markets with a focus on program development, program enhancements, managing interdependencies and risks, program status and evaluation, program growth/expansion in both new and existing markets.

Required Education :
RN-Bachelor's Level Degree

Licenses and Certifications:
Required: Registered Nurse

*A minimum of 3 years of experience in or with Medicaid, disability related programs and/or Long Term Service & Support required.
*A minimum of 3 years of management experience required with proven outcomes in managed medical care delivery system preferably providing services to long-term care, community based services, Medicare, Medicaid, Duals and/or Special Needs Programs.
*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.

Time:  Full time
Salary:  Salary
Category:  Operations

Updated: 12/7/2016 1:56:28 PM

Job Contact:
Richelle Demps

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4417 Corporation Ln
Virginia Beach, VA 23462