Virginia Premier Health Plan, Inc.

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Manager, MLTSS

Manager, MLTSS

Job Locations 
US-VA-Glen Allen
Job ID 
2017-4174

Job Description

Overview

The Manager of MLTSS is responsible for assisting the AVP of Managed Long Term Services and Supports (MLTSS) with all aspects of the MLTSS line of business including program development,  marketing, competitive analysis, strategy and design, implementation and delivery of services to targeted population. The Manger will interface with the corporate PMO and project leads across business areas as well as work closely with Compliance and operational areas to ensure that all operational activities are compliant with state and federal requirements.

Responsibilities

  • Assist with overseeing various operational departments to ensure that the MLTSS plan performance is consistent with the Department of Medical Assistance Services (DMAS) regulatory requirements.
  • Acts as the operational lead to ensure that all state and federal requirements are implemented timely and correctly.
  • Provides oversight for the day to day operations of the MLTSS product line to support continued growth and ability to meet regulatory and contractual obligations
  • Works closely with the operational areas to inform them of new requirements and changes to existing requirements.  
  • Assists the operational areas with implementation of new requirements.
  • Provides functional and technical support regarding the MLTSS product requirement
  • Collaborates with operational departments to effectively oversee projects, identify resources, resolve issues and mitigate risks.
  • Designs, develops and implements business processes and project plans to meet state and federal business requirements.
  • Develops and implements plans to identify root causes and actions necessary to resolve identified operational issues. 
  • Facilitates development of various reporting tools to monitor operational functions and identify opportunities for improved performance, including development and analysis of reports.
  • Tracks and reports product key performance indicators.
  • Keeps current with changing government regulations as it relates to MLTSS.
  • Supports AVP and other team members to ensure overall department objectives are met.
  • Assists in overseeing the timely filing of all submissions with the state government and ensures that all federal and state regulations and guidance are followed in the process. 
  • Leads the planning, development and implementation of new benefits and benefit enhancements.
  • Regularly monitor regulatory and/or governmental policy/methodology updates and industry news to assess and address potential company and/or departmental impact related to the MLTSS product line.
  • Develops/implements the necessary action plans to oversee project implementation to meet corporate business goals for the MLTSS line of business.
  • Ensures regulatory and reporting compliance to State and Federal stakeholders.
  • Ensures ongoing programmatic excellence for the MLTSS program.
  • Provides leadership in development of inter-team communication and cohesiveness.
  • Works collaboratively with the senior management team of each operational area to integrate cross program activities and functions for the MLTSS program.
  • Develops and supports strategic relationships with stakeholders including key state partners and vendors

 

Qualifications

MINIMUM EDUCATION REQUIREMENTS

  • Bachelor’s degree in business, social services administration, public health, nursing, social work or allied health professions. 
  • Master's degree preferred.

SPECIAL KNOWLEDGE AND/OR SKILLS

  • A minimum of three (3) years’ experience in managed care operations, project management, business analysis experience, or related experience.
  • Proficient in Microsoft Office computer applications such as Excel, Outlook, Word, and Power Point.
  • Previous experience as a lead in a functional area, managing cross functional teams.
  • Experience leading cross functional business teams.
  • Strong analytic skills.
  • Exceptional written, verbal and presentation communication skills.
  • Working knowledge of Federal and State policy initiatives that relate to the care and funding of those who qualify for Medicaid and/or MLTSS
  • Demonstrated successful leadership skills in program management, program execution and program development
  • Successful leadership and management experience building effective teams, managing cross-functional teams
  • Demonstrated experience and effectiveness in motivating and mentoring others who are not in a direct reporting relationship.

WORK BACKGROUND/EXPERIENCE

  • Minimum of 3 years leadership and healthcare management experience

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position.

About Us

Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

 

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

 

Our mission is to inspire healthy living within the communities we serve!

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