Long Term Services and Supports (LTSS) Program Manager 7/31/2018
Commonwealth Care Alliance
JOB DESCRIPTIONAPPLY VACANCY NO
Long Term Services and Supports (LTSS) Program Manager
The Long Term Services and Supports (LTSS) Program Manager ensures a) external relationships are in place, performing effectively and well partnered with CCA, so that CCA s enrollees with LTSS needs are being met to ensure quality and to maximize independent living in the community in a cost effective manner; b) ensure providers are educated regarding internal processes, policies and structures to enhance CCA s partnerships and ensure quality services to its members; c) monitor and work with LTSS providers to assure services are properly administered for our members with the highest quality programs.
The LTSS Program Manager reports to the Senior Director of Provider Engagement. Commonwealth Care Alliance s Provider Engagement team is responsible for the building and maintaining of relationships with key provider partners to achieve the organization s network partnership and performance objectives. Position will focus on establishing and maintaining robust programmatic collaboration, communicating with provider partners on program performance, addressing provider issues, and facilitating efficient and effective implementation of the company s model of care and strategic objectives.
* 7+ years experience managing disability-related medical, behavioral, or long term supports program
* Past experience with care or care management for populations with complex medical, behavioral health, and/or social needs
* Bachelor s Degree required in a social science or health science
* Master s Degree preferred
* Working knowledge of Medicare and Medicaid (MassHealth)
* Demonstrated knowledge of DMH system and waiver programs helpful.
* Experience or knowledge of community based services for seniors and disabled individuals, including extensive knowledge of the ASAPs.
* Familiarity with and full support of independent living, recovery, and person-centered planning philosophy and strategies;
* Excellent collaboration and communication skills with the ability to partner effectively across the organization and with external partners to build a robust LTSS capacity.
* Strong strategic thinker and tactical performer
* Strong project management skills with the demonstrated ability to handle multiple projects.
* Demonstrated ability to establish and manage performance and outcome metrics.
* Ability to establish and maintain positive and effective work relationships with internal staff, external vendors, and state and federal agencies
* Proven skills, knowledge base and judgment necessary for independent decision-making
* Excellent organizational, time-management and problem-solving skills
* Polished, professional presentation skills in working with key provider partners and internal leaders.
* Onboards, trains, and provides ongoing inter-face with CCA s contracted network of relevant LTSS service delivery providers (e.g., Long Term Service Coordinators (LTSCs), Geriatric Support Service Coordinators (GSSCs), ASAPs, ILCs, Arcs, and all other key LTSS partner organizations).
* Plays lead role in developing CCA policies and procedure and trainings as they relate to LTSS.
* Manages analyses and utilization and cost review oversight activities to assess the extent to which LTSS needs and resulting service authorizations are being systematically addressed across populations.
* Monitors the performance of all LTSS service providers under contract with CCA, and provides feedback on performance that includes Enrollee satisfaction with Coordinator services and other contracted vendors.
* Oversight of provider performance, including working closely with the Contracting Department in development of pay for performance reimbursement structures and being responsible for monitoring provider reports to assure metrics are being met.
* Works with CCA Provider Network Management staff, including Contracting, and other program leadership to maintain and improve relationships with LTSCs, GSSCs, ASAPs, ILCs, Arcs RLCs, and other key LTSS providers, including successes and challenges in LTSS access.
* Manages information, education and training to CCA staff, clinicians employed by CCA s clinical groups, contracted health home and other providers on LTSS options, service delivery models and contractors, and member understanding of the LTSC role.
* Ensures that CCA regulatory obligations regarding LTSS reporting are met in a timely and accurate manner
* Manages the creation and accuracy of monthly LTSC and GSSC reports
* May be responsible for other ancillary provider types as assigned.
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable).
Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
CCA is committed to protecting the health of our workforce and our members, and we encourage flu vaccination in accordance with CDC recommendations. Individuals working in clinical care areas or in direct contact with members must provide documentation of flu vaccination, or wear a mask during flu season whenever engaged in member-facing activities.