LTSS Process Improvement Professional

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a LTSS Process Improvement Professional based in United States.

This remote role supports Medicaid implementation and operational readiness across new state markets.
You’ll help translate business strategies, regulatory requirements, and contractual obligations into clear, actionable documentation.
The position offers meaningful exposure to policies, workflows, training materials, and operational tools that directly support members and providers.
You’ll collaborate closely with senior process improvement professionals, subject matter experts, and cross-functional teams.
Your work will help create scalable, repeatable processes while maintaining quality, compliance, and consistency.
The role is well suited to a detail-oriented professional who enjoys research, documentation, organization, and continuous improvement.
It also provides an opportunity to deepen your expertise in Medicaid, LTSS operations, and large-scale implementation initiatives.

• Support the development and maintenance of implementation materials, including policies, procedures, program descriptions, letters, assessments, and other operational documentation.

• Review member and provider materials to identify inconsistencies, quality issues, and potential compliance gaps, helping ensure alignment with state requirements.

• Prepare documents for internal review and approval while maintaining accurate version control, file organization, and coordination with subject matter experts and reviewers.

• Support the development and review of training materials and job aids, providing content clarification and feedback to training teams.

• Document business processes, create visual workflows, and develop initial workflow drafts for review and refinement by senior team members.

• Assist with the creation and maintenance of clinical auditing tools and other operational resources used across multiple markets.

• Support the setup and documentation of shared mailboxes, fax numbers, and other communication resources required for new state implementations.

• Research contracts, regulatory requirements, internal resources, and stakeholder input to support accurate implementation materials.

• Track documentation and submission activities using project management and collaboration tools such as Smartsheet, OneNote, and SharePoint.

• Participate in meetings and working sessions, capture key decisions and action items, and follow up on assigned deliverables.

• Help interpret contractual requirements and translate them into clear summaries or draft documentation for senior review.

• Perform quality checks to ensure documentation is accurate, clear, properly formatted, and aligned with submission standards.

• Contribute to special projects and stretch assignments that strengthen operational readiness and advance process improvement initiatives.

Requirements

• Bachelor’s degree or three years of equivalent professional experience in health plan operations.

• At least two years of experience supporting LTSS Provider, LTSS Care Management, or LTSS Utilization Management functions.

• Strong attention to detail with the ability to review complex information and produce accurate, well-organized documentation.

• Ability to research and interpret contracts, regulatory materials, operational requirements, and stakeholder input.

• Strong written and verbal communication skills, with the ability to explain information clearly to both technical and non-technical audiences.

• Strong organizational and time-management skills, including the ability to manage multiple deliverables and deadlines simultaneously.

• Ability to work effectively in a cross-functional environment and collaborate with senior professionals, subject matter experts, and business stakeholders.

• Familiarity with project management principles and experience supporting implementation or process improvement initiatives is preferred.

• Experience with Medicare/Medicaid integrated models is preferred.

• A continuous-improvement mindset and willingness to take ownership of assignments, identify issues, and contribute practical solutions.

• Ability to work independently in a remote environment while maintaining appropriate confidentiality when handling protected health information and other sensitive data.

Benefits

• Competitive annual base salary of $65,000–$88,600 , depending on location, skills, experience, education, and other job-related factors.

• Eligibility for a bonus incentive plan based on company and/or individual performance.

• Medical, dental, and vision insurance .

• 401(k) retirement savings plan .

• Paid time off, company holidays, and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Additional programs supporting employee wellness and whole-person well-being.

• Fully remote work arrangement within the United States.

• Occasional travel may be required for training or meetings.

• Work-from-home setup with a dedicated, interruption-free workspace and reliable internet connection required.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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