Senior Director, LTSS Clinical Care Management

Emploi pas sur LinkedIn

🕒 il y a 21 jours

🇺🇸 États-Unis – Télétravail

💵 $146 000 - $269 600 / an

⏰ Temps Plein

🟠 Senior

👔 Directeur

👻 Score fantôme 1%

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

• Lead and direct long-term care management for members with physical/medical and/or behavioral/mental health care needs • Develop and assess high-quality, cost-effective healthcare outcomes • Lead and develop care management strategies and objectives to improve member and provider experience • Oversee development, implementation, monitoring, and ongoing improvement of the long-term care management process • Provide senior leadership with vision and direction for the department and communicate goals to the care management team • Oversee work assignments and caseloads based on state requirements, staff experience, and member needs • Monitor, review, and sign off on contract-required reporting • Provide vendor oversight as applicable • Lead and enforce long-term care management policies and procedures for compliance with corporate, state, and NCQA standards • Attend conferences and stay current on trends and best practices in payer care management • Lead and coordinate large or special projects with other departments • Provide subject matter expertise to senior leadership and the care management team • Review and monitor long-term care member data to identify trends and improve operating performance and quality of care • Participate in internal and external audits • Review internal reports for budget adherence and forecasting trends • Implement strategies aligned with organizational objectives • Support onboarding, hiring, and training of new team members • Coach and guide the care management team to improve member and provider experience and deliver high-quality care • Lead process improvements and present results to senior leadership • Perform other duties as assigned • Comply with all policies and standards

🎯 Exigences

• Must reside in Indiana or be willing to relocate to Indiana • Minimum of 5 years of LTSS experience required • Graduate from an Accredited School of Nursing or a Bachelor's degree and 10+ years of related experience, including prior management experience (positions primarily overseeing RN team members) • Master's degree or graduate from an Accredited School of Nursing and 10+ years of related experience, including prior management experience (positions primarily overseeing BH team members) • Equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position may qualify • 5+ years management experience preferred • Expert knowledge of industry regulations, policies, and standards preferred • Highly advanced clinical knowledge and ability to assess member needs in context of relevant diagnoses, treatment plans and goals, and identify potential gaps in care or risks for readmission or complications preferred • Strong knowledge of healthcare managed care principles preferred • Experience working with providers and healthcare teams to develop appropriate long-term service plans/care plans preferred • Strong knowledge of medication indications and side effects preferred • Current state's Registered Nurse (RN) license preferred for positions overseeing RN team members • Licensed Clinical Behavioral Health Professional or RN based on state contract requirements (e.g., LCSW, LMSW, LMFT, LMHC, and RN with BH experience) required/preferred for positions overseeing BH team members

🏖️ 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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