The Director is responsible for the overall planning, implementation and evaluation of CalOptima’s Long Term Support Services (LTSS) programs which include Long Term Care (LTC), Community Based Adult Services (CBAS) and the Multi-Senior Services Program (MSSP). The incumbent ensures high quality and responsive service for CalOptima members residing in LTC facilities or who participate in community based LTSS programs. Accountable for LTSS department’s continuous compliance to contractual, regulatory, and accreditation standards. Stays current with industry developments and regulatory changes that may impact CalOptima programs.
POSITION RESPONSIBILITIES:
- Manages the planning and budgeting needs for the LTSS department.
- Oversees management staff for LTC, CBAS and MSSP programs.
- Coordinates policy analysis, program development, community and outreach/education either through direct implementation or in support of initiatives originating in other departments.
- Ensure performance standards are met by monitoring, evaluating and providing feedback to the executive team and department staff.
- Develops and maintains ongoing orientation and training for managers and staff.
- Ensures that all LTSS provided by contract relationships or directly by CalOptima comply with relevant regulations and policy guidelines.
- Serves as a liaison to community based and governmental agencies that serve CalOptima’s senior/disabled and LTSS population.
- Monitors and ensures compliance with federal and state contracts, the National Quality Assurance Committee (NCQA), grant requirements, and other requirements set forth by other regulatory agencies or funding sources.
- Serve as a resource for CalOptima and its health networks.
- Other projects and duties as assigned.
Required Skills
- Interact effectively and influentially with various individuals and groups across the business.
- Manage multiple complex projects with varying customer requirements.
- Analyze data and prepare reports.
- Think strategically to align development efforts with business needs.
- Make decisions based on individualized facts and circumstances.
- Communicate effectively, both verbally and in writing, with internal and external contacts.
- Plan, develop and administer effective programs for seniors and persons with disabilities.
- Effectively manage and lead staff to develop effective working relationships both internally and with community-based organizations, other government agencies and with the population being served.
- Present to various groups or organizations when necessary, [e.g., CalOptima’s Board of Directors, the Member Advisory Committee (MAC), Provider Advisory Committee (PAC) and the Quality Assurance Committee (QAC)]. Represent CalOptima and the LTSS Department at meetings internally and externally, as needed.
- Effectively utilize computer and appropriate software (e.g., Microsoft Office Suite or similar programs).
- Work under the pressure of strict deadlines on multiple projects in a fast-paced environment.
Required Experience
EXPERIENCE & EDUCATION:
- Bachelor’s degree in Nursing or Social Work or equivalent work experience. Note equivalent work experience in lieu of a Bachelor’s degree will be approved by HR and the hiring manager.
- Master’s degree in Health Administration, Public Health, Gerontology, or Licensed Clinical Social Worker is strongly preferred.
- 7 years of related experience, including 5 years of experience at a management level required.
- Some experience in a government or public environment desired.
- Experience in the development and implementation of new programs.
KNOWLEDGE OF:
- Managed Care principles, Medicare and Medi-Cal guidelines specifically related to Long Term Support Services.
- Principles and techniques of effective supervision, including training and evaluation.
- Principles and practices of health care, health care systems, and medical administration.
- The specific and unique needs of the senior and persons with disabilities population.
Grade: Q
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