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CareSource Management Services LLC Manager, LTSS Provider Relations Dayton, Ohio

Job Summary: The Manager, Provider Relations-LTSS is responsible for overseeing and encouraging the collaboration with LTSS/HCBS providers and key stakeholders in the implementation of specific strategies for enhanced operational engagement, overall provider satisfaction, operational performance and compliance of the LTSS and HCBS provider network. Essential Functions: Oversee the ownership of provider relationships through providing proactive, high-level account development and support to drive the overall satisfaction, engagement and retention of LTSS & HCBS provider network. Assists with the development and evolution of the team's strategic direction, annual goals and objectives, recommends new processes and changes for increased department productivity ensuring goals and objectives are met. Ensure the ongoing training and development of Provider Relations Team to support LTSS and HCBS provider relationships; interview, select and train new team members. Collaborate with the Integrated Care's business and technical architectures including Medicare, Medicaid, NCQA and other governing bodies. Oversee day to day operations and ensure compliance with program requirements and initiatives to drive CareSource, ODM, CMS, NCQA and State/Federal requirements and deliverables Lead in a matrixed environment, all resources, task planning and progress reporting related to LTSS network. Identify and manage risk, implement mitigation strategies and communicate/escalate to stakeholders. Establish and maintain strong working relationships with key internal and external business leaders. Manage issue resolution and escalation and ensure LTSS/HCBS Provider Relations team members are resolving complex, non-routine questions, issues, and problems timely, efficiently and effectively. Analyze current work processes, identify gaps and implement proactive, innovative approaches. Develop and report on key accomplishments and issues to leadership. Participate and collaborate in quality and cost savings initiatives. Develop, implement and manage an onboarding and education process. Outwardly support and communicate CareSource mission and goals. Ensure appropriate documentation of interactions and projects by all team members. Conduct team meetings to establish and execute on detailed tasks. Lead and manage the initiatives through their life cycle. Create and manage timelines (milestones) and task schedules. Collaborate with senior leadership to ensure initiatives are properly resourced and managed. Produce detailed reports and business decision documents. Provide clarification/verification for all levels regarding status/details. Incorporates effective change and risk management controls. Conduct performance management activities for direct reports, to include one-on-one meetings, performance appraisals, and discipline as appropriate. Perform any other job-related instructions as requested. Education and Experience: Bachelor's Degree in Business Administration, or related field or equivalent years of relevant experience is required. Minimum of five (5) years of experience in the health plan/managed care industry is required. Minimum of three (3) years of experience in Provider Relations is required. Advanced knowledge of Medicaid, Medicare, MyCare, LTSS, HCBS, and Ohio Home Care Waiver is required. Previous leadership/management experience is required. Competencies, Knowledge and Skills: Proficient with Microsoft Office to include Word, Excel, and PowerPoint Excellent written and verbal communications skills Ability to develop, prioritize and accomplish goals. Detail oriented Strong interpersonal skills and high level of professionalism Effective listening and critical thinking skills Effective problem-solving skills with attention to detail Ability to work independently and within a team Strong n

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