Job Details
Description
Responsibilities
The LTSS Program Manager (aka RVP, Operations/ COO) is dedicated full-time to the Indiana Pathways Program. The LTSS Program Manager (aka RVP, Operations/ COO) oversees day-to-day operations of the Indiana Pathways program, implementing strategic plans and fostering key relationships with stakeholders. They promote intradepartmental coordination, data and trend analysis, and quality improvements, establishing long range goals, objectives, and plans that evolve along with the needs of members, providers, and FSSA. They also monitor financial and operational performance, ensuring adherence to contract requirements and performance goals.
Responsibilities
Directs and coordinates day-to-day plan functions, including reporting, claims administration, encounter data quality, grievances and appeals, member services, provider services, and business continuity planning and emergency coordinationLiaises between FSSA, plan leadership, and corporate leadership responsible for the execution of contract deliverablesWorks with the President to maintain important stakeholder relationships throughout IndianaLeads internal infrastructure to review and improve operational functionsManages implementation of strategic plans developed in cooperation with the PresidentOversees development and maintenance of operational policies and proceduresEffectively implements business plans and oversees audit processesOwns execution of daily operating objectives and goals, including key performance metricsPlans organizational growth and potential staff successionsDevelops and cultivates a diverse and inclusive environmentMaintains intimate familiarity with contractual requirements and stipulationsUnderstands and actively manages ongoing adherence to local, state, and federal regulatory and programmatic requirementsMitigates risks potentially impacting the state of Indiana and the plan by proactively monitoring any risk factors and red flags that may arise during operationsCommunicates with FSSA and direct plan/corporate leadership regarding any necessary operational or regulatory changesLeads conflict resolutions to maintain positive relationships with members, providers, FSSA, subcontractors, and other stakeholders
Required Qualifications
Bachelor's degree in Business, Operations Management, Healthcare Administration, or related fieldMinimum 5 years of prior experience in administering managed long-term care programs OR Equivalent experience in administering long-term services and supports programs, including HCBS (Home and Community Based Services), or Manage Care Health plan operations3 or more years of Leadership experience in a management roleExperience leading departmental activities to ensure accurate and timely accounting, financial and statistical reportsCandidate will reside in the state of Indiana or willing to relocate there within 3 - 6 months of hire.Must be able to travel in-state and willingness to commute to Indianapolis, IN on a weekly basis for leadership and state meetings
Preferred Qualifications
Master's degree in Business, Operations Management, Healthcare Administration, or related fieldExperience in strategic and thought leadership in supporting Medicaid health plans
Additional Information
This position reports directly to the President, Humana Healthy Horizons in IndianaThe state calls this role LTSS Program Manager at Humana the role is leveled as a Regional VP, Operations
Scheduled Weekly Hours
40
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