Search HIPusa.com

Visitors Options

Director, Managed Long Term Care

Medicare Advantage Administration

Location: 55 Water St.

DMLTC MAA

Essential Duties:

Manage and direct the proper functioning of the EmblemHealth Managed Long Term Care (MTLC) Program
Complete SDOH MAP Program Application
In Conjunction with the PMO Office, develop a three-year Business Plan that includes Enrollment Projections and P&L’s
Develop Budget, Staffing Plan and Project Plan (for implementation)
Recruit and supervise the members of the MLTC Team
Work with Medical Affairs to design an Integrated Delivery Model and build network, submit HPN filing and secure SDOH network approval
Responsible for all MLTC compliance issue an the execution of ongoing MTLC operational requirements
Act as the contact person for New York State and coordinate all NTS reporting requirements

Knowledge Skills & Abilities:

Effective written and verbal communication skills
Ability to recognize and determine business course of action with decisiveness
Strong analytical and organization skills
Demonstrated ability to recruit, manage and supervise staff
Demonstrated ability to form successful working relationships (internally and externally)
Demonstrated ability to work with executive-level staff (including government regulators) and cross-functional teams to solve problems and accomplish complex tasks.

Qualifications:

Bachelor’s degree required with Master’s Degree in business, administration or management preferred
Registered Nurse or similar degree a plus
Five years managed Medicare and/or Medicaid operational experience in a managed care organization, including three years experience at the manager level or above.
Proficient in Microsoft Office (Word, Excel)