Director, Care Management – LTSS

Emploi pas sur LinkedIn

🕒 il y a 1 mois

🌽 Illinois – Distant

🌽 Illinois – Remote

💵 $127 300 - $236 100 / an

⏰ Temps Plein

🔴 Expert

👔 Directeur

👻 Score fantôme 39%

Ce que ça veut dire : la probabilité que personne ne recrute vraiment pour cette offre.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Centene Corporation

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10 000+ employés

Fondée en 1984

🛡️ Assurance

💼 Conseil

🏥 Santé

Insurance • Consulting • Healthcare

La société Centene Corporation est un leader dans la fourniture de services de santé subventionnés par le gouvernement, spécialisée dans la délivrance de solutions de santé abordables et de haute qualité. Depuis plus de 40 ans, Centene s’est concentrée sur la transformation de la santé des communautés en élargissant l'accès aux services de Medicaid, Medicare, et au marché de l'assurance santé, tout en servant les communautés militaires à travers le programme TRICARE. En tant que plus grande organisation de gestion des soins Medicaid et un acteur clé du marché, Centene met l'accent sur une prestation de soins de santé localisée combinée à des partenariats solides avec des organisations à but non lucratif pour répondre aux besoins uniques de ses membres. Centene s’engage également pour le développement durable et la responsabilité sociale des entreprises, en privilégiant la gestion environnementale et la gouvernance éthique afin d'améliorer le bien-être des communautés qu’elle dessert.

Description

• Direct long-term care of members to develop and assess high-quality, cost-effective healthcare outcomes • Develop strategies and objectives for long-term care management to improve member and provider experience • Lead long-term care management and the care management team on performance, improvement, and career growth • Lead policies and procedures to ensure compliance with corporate, state, and NCQA standards • Oversee and monitor staff work assignments and caseloads • Monitor, review, and sign off on contract-required reporting • Provide vendor oversight as applicable • Attend conferences and stay current on payer care management trends and best practices • Lead and present process improvements to achieve cost-effective healthcare results • Lead and coordinate large or special projects with other departments • Direct and evaluate departmental operations, including care management model, staffing, information technology, onboarding, and staff competencies • Review and monitor long-term care member data to identify trends and improve operating performance and quality care • Participate in internal and external audits • Contribute to clinical care pathways that enhance cost effectiveness while providing quality care • Develop strategies and influence decisions through recommendations aligned with organizational objectives • Coach and guide the care management team to improve member and provider experience and facilitate high-quality care • May develop the department budget with interdepartmental and senior leadership collaboration • May develop or contribute to onboarding, hiring, and training strategies • Serve as a consumer advocate for MLTSS enrollees in the Illinois Health Plan, including input into policy development, planning, decision-making, and oversight • Perform other duties as assigned • Comply with all policies and standards

🎯 Exigences

• Bachelor's degree • 7+ years of related experience • Prior management experience • Deep expertise in LTSS and Waiver programs • Experience presenting to leadership • Ability to analyze data • Ability to drive performance outcomes • Managed care experience strongly preferred • Must reside in Illinois or be open to relocating • Must be comfortable leading care management operations in Illinois • Knowledge of corporate, state, and NCQA standards • Ability to oversee long-term care management staff, assignments, and caseloads • Ability to review member data and comply with state and federal regulations • Experience or capability in vendor oversight, reporting, audits, care pathways, onboarding, hiring, and training • Equivalent experience may substitute for the stated education/experience through applicable knowledge, duties, scope, and skill

🏖️ Avantages

• Competitive pay • Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity

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