Your career starts now. We’re looking for the next generation of health care leaders.
At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.
Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.
The Director LTSS assists the Administrator with statewide program execution for Home Based Care and Nursing Facilities services programs and leads the development, evaluation and implementation of technical clinical operating systems, in collaboration with IS and other corporate partners and stakeholders. This position plays a vital role in determining organization structure/ development, process flows and policies/procedures to support the clinical aspects of the LTSS program, maintains and evaluates these operational processes, policies and procedures on an ongoing basis to support LTSS care delivery. Serves as an internal consultant to the Medical Director and Provider Network Contracting regarding LTSS services and providers in the State. Serves as subject matter expert for LTSS training for internal care teams and external audiences. Supports coordination of LTSS with other clinical and social services across the continuum of care striving to enhance the quality of member care, including participation on multidisciplinary care teams as indicated.
Responsible for meeting all service coordination requirements of State contracts. Ensures quality and performance metrics are consistently met as specified by State contract and internal standards. Maintains operational processes, policy and procedures to support LTSS care delivery within scope of clinical aspects of program.
Bachelors degree preferred.
RN licensure in state of PA required.
5-10 years of leadership experience to include 3 to 4 years of experience with Home and Community Based Services.
Progressive responsibility in business or government, with health care management PREFERRED
Thorough knowledge of Long Term Care and Home and Community Based Services (HCBS) guidelines, rules and requirements.
Strong experience with Medicaid, Medicare, Dual Eligibles and LTSS populations.
Previous management experience including hiring, training and performance management.
Experience in developing and implementing new health care program initiatives highly desirable.
Experience in evaluating and developing technical clinical operating systems in collaboration with IS and internal stakeholders.
Understanding of shared functional clinical service coordination/coordinators staffing mode.
Leaders in health care solutions for those most in need
AmeriHealth Caritas is the nation's leader in providing comprehensive health care solutions for those in most need and the chronically ill. We impact the lives of more than 5.7 million members nationwide. With more than 30 years of experience managing care for individuals and families in publicly-funded programs, we have become known for d...eveloping innovative solutions that help improve health outcomes while reducing costs.
Our mission, our goal
Our mission is to help people get care, stay well and build healthy communities. Our goal is to provide responsible managed care solutions, including Medicaid, Medicare, and CHIP - plus behavioral health, pharmacy benefits management and third-party management and administrative services.
Through outreach and grassroots advocacy, we develop a firm understanding of the unique health care needs of each community we serve. This allows us to customize our programs to best improve the health of those who call the community home.
At every step of the way, we make it a point to keep care at the heart of our work - just as we have for the past three decades.