Job: Manager, Managed Long-Term Care Support Services

Location:   Trenton, NJ 08601

Job Summary:

This position is responsible for the development, contracting, training and ongoing management of a statewide, comprehensive and accessible network of Managed Long-Term Support and Service (MLTSS) providers. MLTSS span a broad range of up to 30 different provider types including facility-based services such as Skilled Nursing Facilities (custodial and rehabilitative), Assisted Living Centers and Personal Care Homes as well as community-based services, such as Day Health Centers, In-Home Support Services, Personal Care Assistants and Home Delivered Meals. Providers of technology, such as Medication Dispensing Devices and Personal Emergency Response Systems as well as non-clinical services, such as home and vehicle modifications are included as well. . This position is responsible for fostering relationships with these MMLTSS providers to maintain servicing levels and provider satisfaction. The incumbent is responsible for the administration of the MLTSS Network Services department including maintaining adequate staffing, structure and policies. This position is responsible for maintaining a cost effective quality MMLTSS network and managing unit costs. The position will report to Director, MLTSS Program.

Responsibilities:

• Responsible for strategy, oversight, contracting and management of MLTSS provider network long term care facilities and services.


• Develops initial orientation and ongoing training programs for MLTSS providers focusing on MMLTSS Network policies and procedures, quality assurance program, claims processing, resolution of provider complaints and grievances, etc.


• Works in tandem with MLTSS Care Management and Quality Director s to identify gaps in MLTSS provider network, provider training opportunities and quality concerns. Develops coordinated strategies to address said gaps, develop training programs and resolve quality issues.


• Identifies medical, dental and behavioral health providers who specialize in treatment of special needs populations requiring MLTSS, such as frail elderly or disabled persons. Works with HNJH Provider Network Director to recruit and contract with said providers.

• Responsible for maintenance of state standards and compliance with contract and regulatory standards.


• Works as a creative resource on MLTSS model alternatives, reimbursement strategies and options, and alternatives for differentiating HNJH in the contracting marketplace.


• Works with management team to develop and implement MLTSS networking strategies that advance the vision of the company and support HNJH 's corporate goals related to quality, costs and market share.


• Assures that appropriate processes, structure and staff are in place to support proactive provider partnerships throughout all phases of network development, maintenance, service and review.


• Develops and implements strategies to improve provider satisfaction and build working relationships.


• Responsible for managing unit costs.


• Responsible for fee schedule, pricing management, impact analysis and contract results.


• Evaluates the effects of MLTSS network strategies on internal operations and secures buy-in on the part of the leadership team to changes that may be needed.


• Develops and maintains appropriate external relationships in support of the MLTSS network, including providers, regulatory agencies, professional and provider associations.


• Develops solid working relationships with the MLTSS provider community to cultivate mutually beneficial arrangements.


• Monitors and evaluates the external business environment including competitor activity to inform strategic direction.


• Develops and supports appropriate medical-social and administrative cost initiatives.


• Plans and maintains annual budgets. Seeks opportunities to maximize impact of spending.


• Directs staff to ensure overall member satisfaction and appropriate level of service delivery.


• Develops and monitors goals for staff and provides ongoing feedback and coaching.


• Conducts performance reviews on an annual basis and administers salaries for the staff.


• Directs the employment activities of the office that include staffing, development, and training.


• Ensures staff meets all regulatory requirements and comprehends and complies with best practices, professional standards, internal policies, and procedures.

Experience:

• Requires experience working with MLTSS providers.


• Prefer a Master's of Business Administration, Health Administration and Public Health, etc.


• Requires at least ten (10) years' experience with progressive responsibility in health care management.


• Requires supervisory staff management and administrative experience.


• Prefer experience working in a highly regulated government environment.

Knowledge:

• Requires business skills related to community based services, nursing homes and regulatory agencies.


• Requires knowledge of Managed Long Term Support and Services.


• Requires knowledge of strategic planning and development.


• Knowledge of MTLSS pricing and reimbursement and long term care network contracting and servicing functions.


• Knowledge of PC's and applicable software application.


• Knowledge of applicable laws and regulations as well as of Governmental Agencies and Regulatory Bodies.

Skills and Abilities:

• Requires excellent written and oral communication skills.


• Requires leadership and decision making skills.


• Requires demonstrated aptitude for analytical thinking and ability to report findings accurately.


• Requires strong consulting and negotiation skills.


• Requires strong interpersonal, organizational and problem solving skills


• Ability to network and create associations with all level of government and business leaders.


• Ability to develop strategic plans to support company goals.

Education:

• Requires a Bachelor's degree in business, health administration or other related field from and accredited college or university.

Travel:

• Required to cover the State of NJ to maintain MLTSS network relationships. Travel required is a minimum of 20%.

More Info and Application