Director, Long-Term Services & Supports (RN Required) (Remote - Must reside in South Carolina)

Molina Healthcare•Long Beach, SC

2d•Remote

About The Position

The Director, Long-Term Services & Supports (LTSS) leads and directs a multidisciplinary team of healthcare services professionals supporting members with LTSS needs. The role focuses on helping members achieve desired outcomes through integrated care delivery and coordination across the continuum, while contributing to the strategy for quality and cost-effective member care. The position offers remote-work flexibility, but the selected candidate must reside in South Carolina. An RN license is required by the posting.

Requirements

At least 7 years of healthcare experience, including at least 4 years in a healthcare delivery network supporting LTSS and in-home supportive services (IHSS), or an equivalent combination of relevant education and experience.
At least 3 years of healthcare management or leadership experience.
An RN license is required as stated in the posting. The listed clinical licenses or certifications include RN, LPN, LVN, LCSW, APSW, CHES, LPC, LPCC, LMFT, PhD, or PsyD; clinical licensure or certification is required only when required by state contract, regulation, business operating model, or state licensing mandates. Any held license must be active and unrestricted in the state of practice.
Knowledge and experience related to disability and senior access issues.
Demonstrated knowledge of community resources.
Proactive and detail-oriented approach.
Ability to work in varied settings and adjust style when working with diverse populations, personalities, and personal situations.
Ability to work independently with minimal supervision and demonstrate self-motivation.
Responsiveness in all forms of communication and ability to remain calm in high-pressure situations.
Ability to develop and maintain professional relationships.
Strong time-management and prioritization skills, including the ability to manage multiple projects and adapt to change.
Ability to work cross-functionally in a highly matrixed organization.
Excellent verbal and written communication skills.
Proficiency with Microsoft Office and applicable software programs.
Must reside in South Carolina.

Nice To Haves

Experience working with IHSS, public authorities, and community-based organizations (CBOs).

Responsibilities

Oversee the team responsible for delivering LTSS member care.
Serve as an LTSS subject matter expert for care management and service coordination staff, providing direction and guidance to the LTSS care coordination team and ensuring timely, appropriate, quality services and compliance with regulatory timelines.
Ensure compliance with state-specific memoranda of understanding and contract scopes of work.
Assist senior leadership with state-specific LTSS reporting requirements.
Collaborate with leadership to operationalize LTSS activities and oversight.
Participate in county advisory groups and liaise with consumer advocacy organizations, members, caregivers, and community-based organizations to support program integrity and identify development opportunities.
Monitor and report on quality and outcome measures aligned with Molina's clinical and social model of care and LTSS program goals.
Develop policies and procedures guiding integrated services and incorporation of LTSS into individualized care plans.
Oversee LTSS clinical management functions, including contract adherence, assessment, service planning, care coordination, transition planning, and participant and caregiver education and training.
Identify process-change and training needs to improve member services and support model-of-care goals, regulatory requirements, and enterprise standardization.
Develop and facilitate training for LTSS and managed care staff, community-based agencies, delegated entities, and other partners.
Oversee staff use of the electronic case management documentation system, ensuring compliance with company processes, documentation standards, regulations, and HIPAA.
Collaborate with area agencies on aging and state or county agencies to oversee whether member needs are being met.
Oversee assessment and integrated service plan development and monitor compliance with regulatory timelines.
Develop and maintain processes, procedures, and quality reference materials to guide timely assessments, service planning, care coordination, and referrals.
Promote multidisciplinary collaboration, provider outreach, coordination with county social workers or other assigned care managers, and family and caregiver engagement to support continuity of care.
May oversee interdisciplinary care team meetings.
Hire, train, develop, and manage the team; be accountable for team performance and department-specific goals.
Travel locally when required by state or contractual requirements.