Senior Director of Long-Term Care (#2284)
Job Posting for Senior Director of Long-Term Care (#2284) at GLHSTAFFING.COM
JOB TITLE (#2284): Senior Director of Long-Term Care - New York, NY
An established insurance company with locations throughout New York is seeking a Director of Long Term Care Clinical Programs to join its growing team. This company provides the highest quality healthcare services to residents of the Bronx, Brooklyn, Manhattan, Queens, and Staten Island through a comprehensive list of products. They have been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Compensation and Benefits:
- The salary range for this position is $195,000 - $210,000 / yr
- This is a Full-time position
- Health Insurance Plans
- Flexible Spending Account Programs
- Management or Union Benefits
- Leave Benefits
- Special Leave of Absence Coverage (SLOAC)
- Retirement Savings Plans
- Additional Savings Plan
- Transit Benefit
- Direct Deposits
- Municipal Credit Union (MCU)
Requirements:
- Must have a Master’s degree.
- Must have 5 to 7 years of experience working in developing long-term care products, compliance, or a function that provides services to MLTC recipients OR an equivalent combination of training, education, and experience in related fields and educational disciplines; AND thorough knowledge of State and Federal rules and regulations.
- Must have a minimum of 3 years of management, operations, and or Federal and State regulatory compliance experience.
- Must be an experienced healthcare professional who is able to provide direction in a competitive environment and an evolutionary business.
- Must have detailed knowledge of healthcare, specifically managed care and insurance regulations.
- Must have significant and demonstrable experience with Medicaid, Medicare, and Dual Eligible populations and regulations as well as the operational and regulatory requirements around special needs programs.
- Must possess a strong understanding of the healthcare industry marketplace via tenure at a managed care or ancillary healthcare services organization.
- Must have strong analytical, strategic, and planning skills. Must be able to successfully facilitate sound business objectives within a highly regulated industry.
- Must have demonstrated the ability to analyze a marketing challenge and determine appropriate programs and initiatives in response to research reports.
- Must have experience in long-term managed healthcare or ancillary healthcare services industry (e.g., pharmaceuticals, diagnostics).
Responsibilities:
- Responsible for the daily operations of the company’s Managed Long Term Care, PCS, and MAP products
- Plan, direct, and set the strategic direction of the long-term care products
- Plan and direct financial and budget activities to fund operations, maximize contracts, and increase efficiency
- Must be and remain current with all applicable MLTC regulatory requirements for marketing, enrollment, operations, billing claims, etc.
- Coordinate implementation of interdepartmental processes (policies and procedures) related to MLTC, MAP, and PCS business.
- Assist the Regulatory Affairs Department with implementing State and federally-mandated program changes.
- Oversight of the Personal Care Services team as it relates to administering the Personal Care Services benefit for MMC, HIV-SNP, and HARP lines of business.
- Oversight of Long-Term Nursing Home placement for all applicable lines of business.
- Oversight of Adult Day Health Care Medical Model benefit for MMC, HIV-SNP, and HARP lines of business
- Ensure compliance with Medicaid Managed Care Personal Care Services regulations.
- Assist the Communications and Sales Department in the development, review, and approval of marketing, member, and provider-related of other materials. Responsible for ensuring appropriate and compliant materials are produced and disturbed.
- Work with the Regulatory Affairs Department to receive approval for all materials, as they relate to SDOH.
- Responsible for quality clinical operations of the program.
- Responsible for appropriate care to patients in the program.
- Ensures regular Care Plan Meetings.
- Participates in the preparation of policies and procedures in compliance with relevant regulations.
- Establishes policies to achieve program goals, interprets, and executes those policies to achieve safe and efficient patient care.
- Participate in medical cost discussions and evaluate programs to maximize revenue and decrease costs.
- Oversee and develop programs to improve and manage benefit delivery
- Actively participate in all the State Department of Health services (SDOH) site visits, audits preparation, and in any corrective actions; including reviewing survey documents and training departments.
- Works with the Finance Division in developing financial statements, projections, reimbursement rates, and filings and insuring the fiscal visibility of the line of business.
- Works with the Compliance Department to ensure all compliance activities include MLTC products.
Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.
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Salary.com Estimation for Senior Director of Long-Term Care (#2284) in New York, NY
$148,124 - $193,850
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