LTSS and HCBS Provider Network Manager

CareSource•Dayton, OH

7d•$83,000 - $132,800

About The Position

The LTSS and HCBS Provider Network Manager oversees small- to large-scale programs supporting strategic network objectives, including network strategy, contracting, and operational execution. This role ensures alignment with regulatory requirements, enterprise priorities, and market-level business needs across Home and Community-Based Services (HCBS) and Long-Term Services and Supports (LTSS).

Requirements

Bachelor's degree in business administration or related field required
Equivalent years of relevant work experience may be accepted in lieu of required education
Five (5) years Experience in HCBS/LTSS network contracting, provider engagement or network operations required
Previous experience in healthcare, preferably in managed health plan industry required
Strong proficiency with Microsoft Office and collaboration tools (e.g., Word, Excel, PowerPoint, Project, Visio, Teams)
Excellent analytical, problem-solving, and decision-making capabilities
Strong communication, relationship-building, and stakeholder management skills
Proven ability to lead projects, prioritize work, and meet deadlines
Demonstrated sense of urgency and customer-focused mindset
Experience within the healthcare payer environment, including Medicaid and Medicare programs
Excellent written and verbal communication skills
Ability to influence goals and metrics across a heavily matrix organization
Critical thinking and listening skills with strong attention to detail
Analytical mindset with the ability to interpret complex data and make data-driven decisions to improve network adequacy

Responsibilities

Lead delivery of HCBS and LTSS network program initiatives in alignment with market and enterprise strategies.
Interpret business and regulatory requirements to enable effective cross-functional coordination.
Ensure timely completion of program deliverables in compliance with regulatory and leadership approvals.
Drive continuous improvement through adoption of best practices, processes, and tools.
Partner with functional leaders to define, assign, and track work supporting approved network strategies.
Collaborate with market network leadership to ensure programs are appropriately resourced and managed.
Maintain stakeholder engagement and communication, including issue escalation and resolution.
Serve as subject matter expert and liaison for HCBS and LTSS strategic and operational partnerships.
Support operational readiness for RFPs, implementations, onsite readiness, and program transitions (e.g., standalone or MMP to HIDE/FIDE SNP).
Develop market-specific HCBS/LTSS analyses for RFPs, including network landscape, competitiveness, and state requirements.
Support contracting discussions for multi-market HCBS/LTSS network partnerships.
Coordinate development of HCBS/LTSS provider-facing materials, contracting documents, compensation models, and training resources.
Perform any other job related duties as requested.