LTSS Operations Manager

Job Summary

Leading the day-to-day operations of LTSS service determination, the full-time Manager, LTSS Service Determination Operations will ensure accurate, timely, and compliant assessments while collaborating with various stakeholders in a remote environment.

Key responsibilities

• Serve as the primary operational lead for LTSS service determinations, ensuring compliance with state-specific rules and contractual obligations
• Partner with local Care Management, Clinical, Product, and Compliance teams to resolve operational issues and ensure readiness
• Develop and execute training programs for staff while driving continuous improvement initiatives focused on quality and member experience

Required qualifications

• Bachelor's degree required; equivalent experience may be accepted in lieu of education
• Three years of experience in healthcare operations, specifically in LTSS and Medicaid
• Two years of leadership experience managing teams in a healthcare or managed care environment
• Experience with assessment tools such as MDS and functional assessments preferred
• Three years of experience supporting process redesign or system implementation preferred