What are the responsibilities and job description for the LTSS Care Coordination (Dir GBD Special Programs) position at CareBridge?
Preferred Location: Ohio. This position is hybrid and will require the associate to report to 1 of the 4 Ohio office locations at least 1-2 times per week. The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations within the state of Ohio.
MyCare Ohio Plan program is to deliver high-quality, trauma informed, culturally competent, person-centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.
As the LTSS Care Coordination Director, you are entrusted with the fiscal and operational management, implementation, and oversight of the Ohio MyCare Care Coordination team. Your role is essential in aligning care coordination operations with the MyCare contract, fostering a person-centered approach to care, and ensuring compliance with NCQA accreditation standards.
How will you make an impact
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
MyCare Ohio Plan program is to deliver high-quality, trauma informed, culturally competent, person-centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.
As the LTSS Care Coordination Director, you are entrusted with the fiscal and operational management, implementation, and oversight of the Ohio MyCare Care Coordination team. Your role is essential in aligning care coordination operations with the MyCare contract, fostering a person-centered approach to care, and ensuring compliance with NCQA accreditation standards.
How will you make an impact
- Develop and implement the strategic vision, goals, objectives, policies, and decision-making processes specifically for the Ohio MyCare Care Coordination and operations team, ensuring that all actions support the broader organizational mission and NCQA standards.
- Oversee all health plan medical management programs, including person-centered planning, discharge planning, case management, disease management, quality management, and health promotion and outreach, to enhance the MyCare Care Coordination model.
- Facilitate collaboration with medical management staff to identify gaps in process and implement improvements for effective care coordination and service delivery.
- Drive the performance management activities for the program, focusing on recruiting, training, and guiding your team of managers and field staff to achieve operational excellence.
- Engage in fiscal and operational responsibility for the special program, adapting strategies in line with budgetary policies while focusing on continuous improvement and strategic growth.
- Lead hiring, training, coaching, counseling, and performance evaluation of direct reports to build a high-performing team dedicated to delivering exceptional care coordination services.
- Requires a BA/BS and minimum of 10 years relevant experience, including prior management experience in a managed care setting with operations, budgeting and forecasting, process improvement, or planning experience; or any combination of education and experience, which would provide an equivalent background.
- Licensed Independent Social Worker (LISW), Registered Nurse (RN), or Licensed Medical Social Worker (LMSW) within the state of Ohio strongly preferred.
- Certified Case Manager (CCM) strongly preferred.
- MPA, MPH, MSN or MBA with Health Care concentration strongly preferred.
- Experience working as a field-based care coordinator is strongly preferred.
- Experience managing field-based care coordination staff is strongly preferred.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
