Pharmacy Technician assisting in medication distribution and IV admixtures at UMass Memorial Health. Performing medication related tasks under supervision to maintain pharmacy services in the hospital.
CA
Hybrid Director, MyCare HCBS Waiver – Preferred Experience with LTSS, Community Based Services, Medicaid, Waivers/Authorizations
Posted 2 months ago
About the role
- Director responsible for overseeing CareSource MyCare HCBS Waiver and LTSS case management programs. Ensures quality management and compliance while supporting operational and clinical growth.
Responsibilities
- Develop, direct and oversee CareSource MyCare HCBS Waiver and Long-Term Care Services and Supports (LTSS) case management programs
- Assure quality and consistency of MyCare HCBS Waiver care management activities delivered by CareSource staff, delegates, external partners, and contracted vendors
- Develop and provide input to align internal policies, procedures, and goals regarding MyCare HCBS Waiver programs
- Collaborate with the AVP of Integrated Health, assuming responsibility for overall function, operational, clinical, and professional growth of MyCare HCBS Waiver services program
- Establish a team culture that drives excellence in member experience, operations, and quality
- Support Health Services programs by contributing to policies, programs, accreditation, cost, and quality activities relative to MyCare HCBS Waiver program
- Lead the fiscal and regulatory management of MyCare HCBS Waiver Programs
- Ensure high quality case management is delivered within product lines including MyCare Waiver and LTSS services
- Implement and oversee all clinical/care management functions for individuals receiving MyCare HCBS Waiver services
- Manage care management services for CareSource MyCare HCBS Waiver
- Ensure compliance with all contracts, statutes and regulations
- Collaborate with internal/delegate Care Management staff ongoing and share/implement best practices
- Create and monitor MyCare HCBS Waiver work plan
Requirements
- Bachelor’s degree in nursing, social work, healthcare administration or related field, or equivalent years of relevant work experience
- Master’s degree is preferred
- Minimum of seven (7) years of experience with government programs, including at least 5 years of experience in HCBS waiver programs
- Three to five (3-5) years of leadership/management experience
- Managed Care experience is preferred
- Clinical experience in healthcare delivery is preferred
- Intermediate proficiency level with Microsoft Office
- Ability to operate smart phone, iPad, or other mobile communication devices
- Familiarity with provider operations
- Knowledge of clinical guidelines (Milliman, InterQual)
- Knowledge of regulatory requirements for both Medicaid and Medicare
- Strong financial background
- Strong interpersonal skills and a high level of professionalism
- Knowledge of managed care industry, trends, and accreditation
- Knowledge of quality improvement and HEDIS programs/outcomes measurement
- Excellent verbal and written communication skills
- Strategic management skills
- Excellent leadership, management and supervisory skills and experience
- Ability to work independently and within a team environment
- Effective problem-solving skills with attention to detail
- Effective listening and critical thinking skills
- Training/teaching skills
- Negotiation skills/experience
- Customer service oriented
- Ability to develop, prioritize and accomplish goals.
Benefits
- Comprehensive total rewards package
- Influenza vaccination requirement
- Reasonable accommodations for disabilities or medical conditions
- Flexible hours, including occasional evenings and/or weekends
Job title
Job type
Experience level
Salary
Degree requirement
Location requirements
Outreach Phlebotomist performing venipunctures and transporting specimens for UMass Memorial Health. Join a team of caregivers in Central Massachusetts committed to exceptional patient care.
Culture & Community Specialist at Acorns bridging remote and in - office cultures through events and engagement. Leading initiatives for community building and operational excellence in Irvine office.
Community Specialist supporting Clubhouse members through structured activities and engagement. Promoting personal goals and providing assistance in a recovery - oriented environment.
Account & Community Manager at Genentech focusing on rare blood disorders. Engaging healthcare providers and patient advocacy groups to improve patient outcomes in the DC/Baltimore area.
Community Manager at Henry Schein managing social media profiles and digital content strategy. Engaging with the audience and enhancing brand presence through creative communication.
Medical Assistant providing direct and indirect patient care in ambulatory setting under supervision. Collaborating with healthcare team members to meet patient needs and regulatory compliance.
Director overseeing community engagement strategies and subscriber relationship management. Collaborating with teams to drive growth and retention in GS1 Canada’s services.
CX & Community Manager at Nero overseeing customer experience and community engagement in a hybrid work setup. Engaging with customers and supporting operational tasks for a growing activewear brand.
Community & Field Marketer managing outreach and field events for Perplexity’s AI community program. Building user advocacy and driving enterprise pipeline through innovative marketing strategies.