Director, LTSS Partnerships (Plan or Provider experience in LTSS) Remote in MA
**Remote and must live in Massachusetts***
Job Description
Job Summary
The Director, LTSS Partnerships plays a critical role in the development and implementation of strategies related to Molina's relationships with community-based organization that coordinate long term supports and services (LTSS Coordination Organizations) for members.
Accountable for designing and implementing a strategy to continuously improve results of existing initiatives while also leading a continuous process of innovation to identify new initiatives to support Molina's relationships with LTSS Coordination Organizations and to meet or exceed operational, financial, clinical, quality, member satisfaction, compliance, and growth goals. The Director will be working within a highly matrixed organization focused on driving continuous improvements in the described areas.
Job Duties
Primary owner of the strategic relationship with LTSS Coordination Organizations, including both new and existing partners.
Develop relationships with new LTSS Coordination Organizations, working with Network and Healthcare Services to establish initial contract terms and operating procedures.
Manage ongoing relationships with LTSS Coordination Organizations, including leading regular Joint Operating Committee meetings and managing escalated issues.
Lead cross departmental partnerships with Quality, Healthcare Services, Network, Operations, Government Contracts and Community Engagement to ensure all aspects of Molina's relationship with LTSS Coordination organizations meet or exceed operational, financial, clinical, quality, member satisfaction, compliance, and growth goals.
Primary owner of Value-Based Programs and contracts for LTSS Coordination Organizations. In conjunction with Quality, Healthcare Services and Network, develop suggested contract terms (financial and quality metrics and benchmarks, assignment of reporting responsibilities and functions within contract language etc.), set annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, develop and produce reports for Regional Directors and local health plan resources to share on a regular cadence with providers to achieve goals.
Designs and maintains and internal dashboard of Value-Based Programs and Contracts for LTSS Coordination Organizations for internal monitoring and senior leadership management. Ensures consistent measurement of all metrics to enable accurate comparisons and measurement of progress toward annual goals supporting financial forecasts.
Ensures material subcontractor requirements related to LTSS Coordination Organizations are met
Develops and sustains a high-performance team, dedicated to best-in-class solutions, responsible for attracting, developing, and retaining top-tier talent to support strategy and long-term business objectives
Job Qualifications
REQUIRED EDUCATION:
Bachelor's Degree in Public Health, Nursing, Business, Finance or equivalent combination of education and experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
Minimum 8 years managed care experience
Experience working with specific LTSS Coordination Organizations
Experience leading value-based program & contract design and implementation for marketplace, Medicaid, and/or Medicare
Experience in a complex healthcare delivery environment, specifically with government sponsored programs, including strategy and compliance
Experience working in a highly matrixed organization, with proven ability to develop internal enterprise relations and external strategic relationships
Knowledge of value-based programs and quality metrics such as HEDIS and STARS
Excellent leadership skills, with the ability to influence others who are not in a direct reporting line
Ability to think strategically, develop vision, and execute effectively and efficiently for both near and long-term results
Proven ability to innovate and manage complex processes across multiple functional areas
Excellent presentation and communication skills
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
#PJCorp
Apply Now
Job Description
Job Summary
The Director, LTSS Partnerships plays a critical role in the development and implementation of strategies related to Molina's relationships with community-based organization that coordinate long term supports and services (LTSS Coordination Organizations) for members.
Accountable for designing and implementing a strategy to continuously improve results of existing initiatives while also leading a continuous process of innovation to identify new initiatives to support Molina's relationships with LTSS Coordination Organizations and to meet or exceed operational, financial, clinical, quality, member satisfaction, compliance, and growth goals. The Director will be working within a highly matrixed organization focused on driving continuous improvements in the described areas.
Job Duties
Primary owner of the strategic relationship with LTSS Coordination Organizations, including both new and existing partners.
Develop relationships with new LTSS Coordination Organizations, working with Network and Healthcare Services to establish initial contract terms and operating procedures.
Manage ongoing relationships with LTSS Coordination Organizations, including leading regular Joint Operating Committee meetings and managing escalated issues.
Lead cross departmental partnerships with Quality, Healthcare Services, Network, Operations, Government Contracts and Community Engagement to ensure all aspects of Molina's relationship with LTSS Coordination organizations meet or exceed operational, financial, clinical, quality, member satisfaction, compliance, and growth goals.
Primary owner of Value-Based Programs and contracts for LTSS Coordination Organizations. In conjunction with Quality, Healthcare Services and Network, develop suggested contract terms (financial and quality metrics and benchmarks, assignment of reporting responsibilities and functions within contract language etc.), set annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, develop and produce reports for Regional Directors and local health plan resources to share on a regular cadence with providers to achieve goals.
Designs and maintains and internal dashboard of Value-Based Programs and Contracts for LTSS Coordination Organizations for internal monitoring and senior leadership management. Ensures consistent measurement of all metrics to enable accurate comparisons and measurement of progress toward annual goals supporting financial forecasts.
Ensures material subcontractor requirements related to LTSS Coordination Organizations are met
Develops and sustains a high-performance team, dedicated to best-in-class solutions, responsible for attracting, developing, and retaining top-tier talent to support strategy and long-term business objectives
Job Qualifications
REQUIRED EDUCATION:
Bachelor's Degree in Public Health, Nursing, Business, Finance or equivalent combination of education and experience
REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:
Minimum 8 years managed care experience
Experience working with specific LTSS Coordination Organizations
Experience leading value-based program & contract design and implementation for marketplace, Medicaid, and/or Medicare
Experience in a complex healthcare delivery environment, specifically with government sponsored programs, including strategy and compliance
Experience working in a highly matrixed organization, with proven ability to develop internal enterprise relations and external strategic relationships
Knowledge of value-based programs and quality metrics such as HEDIS and STARS
Excellent leadership skills, with the ability to influence others who are not in a direct reporting line
Ability to think strategically, develop vision, and execute effectively and efficiently for both near and long-term results
Proven ability to innovate and manage complex processes across multiple functional areas
Excellent presentation and communication skills
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
#PJCorp
Apply Now