Director Long-Term Services and Support

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Position Summary

The Long-Term Services and Support (LTSS) Director will partner closely with the LTSS Executive Director, Market CEO, and State Medicaid agency to build a transparent and trusting relationship while meeting state objectives.

The Director will collaborate across the enterprise to ensure that the State LTSS program and Aetna objectives are aligned, business strategies are delivered and financial, compliance and quality objectives are met.

The LTSS Director will partner closely with the LTSS Executive Director, Market CEO, and State Medicaid agency to build a transparent and trusting relationship while meeting state objectives.

The Director will collaborate across the enterprise to ensure that the State LTSS program and Aetna objectives are aligned, business strategies are delivered and financial, compliance and quality objectives are met.

Manage staff and develop workforce and organization

Lead, develop, and motivate a high performing team to meet organizational goals and objectives while effectively managing change.

Ensure that processes are aligned with the highest quality standards required by Accreditation and Credentialing Organizations (for example, NCQA).

Oversee and ensure compliance with all applicable Federal and State regulations relevant to the plan’s function. Develop and maintain tools and processes for proactive monitoring for all relevant quality and compliance performance metrics.

Partner effectively with Medicaid Program Integrity operations to meet all LTSS requirements.

Promote a clear vision aligned with company values and direction sets specific challenging and achievable objectives and action plans motivates others to balance customer needs and business success challenges self and others to look to the future to create quality products, services, and solutions.

Implement and monitor the business plan and oversee any implementations or business transitions impacting service operations.

Develop and manage clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction.

Develop and implement staffing models that are consistent, cost effective, and compliant with contractual obligations. Lead recruitment and operating model development to meet operational growth needs.

Foster an environment that supports professional development, mobility, and operational excellence.

Develop, implement, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna Health Services strategies, policies, and programs.

Oversee the implementation and on-going execution of the strategic and operational business plan for the business segment's clinical operations, inbound / outbound call queue, implementation, and / or plan sponsor operations.

Coordinate business segment policies and procedures in support of financial, operational and service requirements. Develop, implement, and evaluate policies and procedures, which meet business needs (may cross multiple business functions).

Direct enhancements to business processes, policies and infrastructure to improve operational efficiency (may cross multiple business functions).

Collaborate and partner with other business areas across / within regions or segments and within other centralized corporate areas to ensure all workflow processes and interdependencies are identified and addressed on an on-going basis.

Develop and participate in presentations and consultations to existing and prospective customers. Participate in internal and external health industry development efforts.

Required Qualifications

• Florida resident
• Active and unrestricted Florida State license - RN, APN, LCSW, LCPC, LMFT
• 5+ Years working in Medicaid LTSS
• 10-15 Years of prior relevant experience
• Ability to develop business cases for new investments and work with finance to secure funding when additional staff are warranted.
• Ability to develop, evaluate and articulate current status, planning, and strategic initiatives via executive level presentations and able to speak professionally to Executive Level audience.
• Ability to successfully motivate, drive and lead colleagues in Manager, Supervisory and field level positions.
• Ability to interpret State contract to ensure Florida market is performing to contract expectations.

Tenure Qualifications

• 5+ Years working in Medicaid LTSS Required
• 10-15 Years of prior relevant experience Required

Preferred Qualifications

• Long-term care leadership experience
• Registered nurse
• Bilingual Spanish
• Master's degree

Education

Bachelor's' degree required for RN license or master's degree in social services / clinical counseling for BH License.

Master's degree preferred.

Pay Range

The typical pay range for this role is :

$99,420.75 - $214,100.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.

The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

This position also includes an award target in the company’s equity award program.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.

Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.