Program Manager, LTSS Contract Operations

LTSS Program Manager

The LTSS Program Manager is responsible for overseeing relationships and performance with community-based Long-Term Services and Supports (LTSS) provider organizations that serve One Care and Senior Care Options (SCO) members across Massachusetts. This role manages the performance of Commonwealth Care Alliance's (CCA) contracted community-based organizations (CBOs), including Aging Services Access Points (ASAPs) and Long-Term Services Coordinators (LTSC) agencies, ensuring alignment with CCA's model of care and strategic objectives.

The Manager fosters effective clinical and programmatic collaboration with provider partners, communicates performance expectations and outcomes, and leads performance evaluation and improvement efforts. Through reporting, data analysis, and partnership management, the LTSS Program Manager ensures that providers meet contractual, regulatory, and quality standards that optimize member outcomes and operational efficiency.

This role is accountable for ensuring that external provider relationships are high-performing, well-coordinated, and fully integrated with CCA operations so that members' LTSS needs are met in a manner that supports quality, independence, and cost-effective community-based care. The Manager also ensures providers are educated on CCA policies, processes, and structures to enhance collaboration and service quality.

This position offers broad exposure across multiple organizational areas and requires close collaboration with internal leadership, operations teams, and external provider partners. The ideal candidate demonstrates strong organizational, analytical, and relationship-management skills, with the ability to engage diverse stakeholders to identify opportunities and drive both program-wide and provider-specific performance improvement.

The LTSS Program Manager reports to the Senior Director of Delegation Partnerships and Provider Engagement. The Provider Engagement team is responsible for building and maintaining relationships with key provider partners to advance CCA's network partnership, quality, and performance objectives.

No, this position does not have direct reports.

Essential Duties & Responsibilities :

• Serve as the primary liaison for assigned community-based LTSS provider organizations, with a focus on ASAPs, LTSCs, and GSSCs.
• Build and maintain strong, collaborative relationships with provider partners to promote transparency, accountability, and mutual success.
• Conduct regular provider meetings (virtual and in-person) to review performance, discuss program updates, and address operational challenges.
• Represent CCA's LTSS model of care and ensure provider alignment with contractual, operational, and quality expectations.
• Partner with internal teams to address provider issues and ensure timely resolution.
• Oversee onboarding, training, and ongoing engagement of CCA's LTSS network, including ASAP and LTSC agencies.
• Lead the monitoring and analysis of provider performance using utilization, quality, and member experience metrics.
• Collaborate with Business Intelligence, Finance, Quality, and Contracting to develop and disseminate performance reports and dashboards.
• Develop, implement, and track provider performance improvement plans in partnership with internal and external stakeholders.
• Ensure compliance with all regulatory and contractual requirements related to LTSS provider reporting and quality standards.
• Maintain ownership of provider guidance materials, ensuring accuracy and consistency across policies, procedures, and training tools.
• Support pay-for-performance and value-based contracting programs through data analysis and performance oversight.
• Support the design, implementation, and continuous improvement of LTSS program operations, policies, and workflows related to ASAPs and LTSCs.
• Collaborate with cross-functional teams to ensure operational alignment and data accuracy, including roster reconciliation, payment processes, and reporting.
• Manage special projects related to program development, process redesign, and strategic growth.
• Maintain an organized reporting inventory and ensure consistent and timely dissemination of performance data to providers.
• Support the development and communication of SOPs, reference guides, and workflows to enhance operational efficiency across LTSS partners.
• Coordinate updates and maintain LTSS provider materials on CCA's Extranet / SharePoint to ensure accurate and accessible resources.
• Work collaboratively with internal departmentsincluding Clinical Operations, Contracting, Network Management, Utilization Management, and Business Intelligenceto align LTSS performance priorities and initiatives.
• Support Provider Engagement leadership in advancing enterprise-wide initiatives related to provider partnerships, care coordination, and program integration.
• Contribute to quality improvement projects, audits, and performance reviews to strengthen LTSS provider engagement and member outcomes.
• Identify and share best practices to enhance provider collaboration and the overall member experience.

This is a remote or hybrid role with the expectation of working according to Commonwealth Care Alliance's standard operating hours of 8 : 30am-5pm Monday-Friday. Ability to travel to provider offices and access to reliable transportation.

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