Director, Care Management – LTSS

🔥 13 hours ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $127.3k - $236.1k / year

⏰ Full Time

🔴 Lead

👔 Director

👻 Ghost score 0%

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Direct long-term care of members to develop and assess high-quality, cost-effective healthcare outcomes • Develop strategies and objectives within long-term care management to improve member and provider experience • Lead long-term care management and care management team 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 • Attend conferences and stay current on payer care management trends and best practices • Lead and present process improvements • Lead and coordinate large or special projects with other departments • Direct and evaluate departmental operations, staffing, information technology use, onboarding and staff competencies • Review member data to identify trends and improve performance and quality of care • Participate in internal and external audits • Contribute to clinical care pathway development and improvement • Develop care management strategies and influence decisions through recommendations • Coach and guide the care management team • Develop department budgets as applicable • Develop or contribute to onboarding, hiring and training strategies • Serve as a consumer advocate for MLTSS enrollees for the IL Health Plan, including policy development, planning, decision-making and oversight • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Candidates must reside in Illinois • Bachelor's degree and 7+ years of related experience, including prior management experience • Equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position may substitute • Deep expertise in LTSS and Waiver programs • Experience leading care management operations • Comfort presenting to leadership • Ability to analyze data • Ability to drive performance outcomes • Managed care experience strongly preferred • Knowledge of corporate, state and NCQA standards • Ability to oversee caseloads, reporting, vendors, audits, staffing, onboarding and staff competencies • Ability to develop and improve clinical care pathways • Ability to develop strategies and recommendations aligned with organizational objectives

🏖️ Benefits

• 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 • Diversity-focused equal opportunity employer