Director Service Coordination and Long-Term Services and Supports, Geisinger Health Plan

Location: Work from home (Pennsylvania)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

Yes

Job Summary:

The Director Service Coordination and Long-Term Services and Supports (LTSS) leads strategy, program design, and implementation for all LTSS/HCBS requirements and functions of the Community HealthChoices agreement. Community HealthChoices (CHC) is Pennsylvania's managed long-term services and supports (MLTSS) program serving older adults and individuals with physical disabilities who are enrolled in Medicare and Medicaid.

Job Duties:

The individual filling this role must live in Pennsylvania.

Frequent travel required to locations across Pennsylvania including attendance at State meetings.

Master's Degree required: Healthcare, Nursing, Social Work, Public Administration, or related field

The successful candidate has an understanding of long-term care services and supports policies, practices, and regulations.

• Supports strategy and implementation of Geisinger Health Plan’s CHC program, inclusive of Service Coordination and Service Integration.

• Develops and oversees implementation of strategic partnerships on behalf of GHP with LTSS providers, community organizations, advocacy groups, associations, vendors, and others.

• Represents GHP as a CHC leader and LTSS subject matter expert in state (DHS/OLTL) forums (e.g., LTSS Subcommittee).

• Prepares GHP for CHC readiness reviews and other routine audits including those of program standards regarding records retention, which are set forth in federal and state law and regulations.

• Monitors, reviews, and recommends executive sign off on contract-required reporting as required.

• Develops policies and procedures to ensure effective and efficient delivery of LTSS programs and services, while ensuring a participant-centered approach.

• Conducts regular assessments of program effectiveness and participant experience and implements program improvements.

• Collaborates with the Geisinger Health Plan Leadership team regarding operational issues, staffing, resources, system, and program needs and presents solution action plan for issues.

• Facilitates and participates in GHP committees, task forces, work groups and multidisciplinary teams as needed to operationalize all aspects of the CHC contract.

• Ensures compliance with state and federal regulations and all CHC contractual obligations.

• Manages budgets, in collaboration with other Leadership team members, to ensure that functions and costs unique to CHC are appropriately funded and reflected.

• Keeps abreast of industry trends and innovations, as well as changes in healthcare laws and regulations, and adjusts programs and services accordingly.

Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.

Position Details:

This position is established specifically to lead and support activities associated to the program award. Employment is contingent upon the award. In the event Geisinger Health Plan is not awarded the Community HealthChoices agreement employment in this position will be discontinued.

Preferred Skills:

• Familiarity with person-centered philosophies, concepts of independence, and/or self-determination.
• Experience working with individuals with disabilities and older adults.
• Track record of building trust-based relationships.
• Strong analytical skills.
• Effective problem-solving and change management skills.
• Able to function well independently in a busy environment.
• Demonstrates excellent verbal and written communication skills.
• Demonstrate effective critical thinking and decision-making skills.

Education:

Master's Degree-Related Field of Study (Required), Bachelor's Degree-Nursing (Preferred)

Experience:

Minimum of 8 years-Managerial/Supervisory (Required), Minimum of 5 years-Health Insurance/Managed Care (Required)

Certification(s) and License(s):

Skills:

Acts Decisively, Care Management Knowledge, Communication, Health Insurance, Leadership, Organizing

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.

• KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
• EXCELLENCE: We treasure colleagues who humbly strive for excellence.
• LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
• INNOVATION : We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
• SAFETY: We provide a safe environment for our patients and members and the Geisinger family.

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.