Job Summary:
The LTSS and HCBS Provider Network Manager oversees small- to large-scale programs supporting strategic network objectives, including network strategy, contracting, and operational execution. This role ensures alignment with regulatory requirements, enterprise priorities, and market-level business needs across Home and Community-Based Services (HCBS) and Long-Term Services and Supports (LTSS).
Essential Functions:
- Lead delivery of HCBS and LTSS network program initiatives in alignment with market and enterprise strategies.
- Interpret business and regulatory requirements to enable effective cross-functional coordination.
- Ensure timely completion of program deliverables in compliance with regulatory and leadership approvals.
- Drive continuous improvement through adoption of best practices, processes, and tools.
- Partner with functional leaders to define, assign, and track work supporting approved network strategies.
- Collaborate with market network leadership to ensure programs are appropriately resourced and managed.
- Maintain stakeholder engagement and communication, including issue escalation and resolution.
- Serve as subject matter expert and liaison for HCBS and LTSS strategic and operational partnerships.
- Support operational readiness for RFPs, implementations, onsite readiness, and program transitions (e.g., standalone or MMP to HIDE/FIDE SNP).
- Develop market-specific HCBS/LTSS analyses for RFPs, including network landscape, competitiveness, and state requirements.
- Support contracting discussions for multi-market HCBS/LTSS network partnerships.
- Coordinate development of HCBS/LTSS provider-facing materials, contracting documents, compensation models, and training resources.
- Perform any other job related duties as requested.
Education and Experience:
- Bachelor's degree in business administration or related field required
- Equivalent years of relevant work experience may be accepted in lieu of required education
- Five (5) years Experience in HCBS/LTSS network contracting, provider engagement or network operations required
- Previous experience in healthcare, preferably in managed health plan industry required
Competencies, Knowledge and Skills:
- Strong proficiency with Microsoft Office and collaboration tools (e.g., Word, Excel, PowerPoint, Project, Visio, Teams)
- Excellent analytical, problem-solving, and decision-making capabilities
- Strong communication, relationship-building, and stakeholder management skills
- Proven ability to lead projects, prioritize work, and meet deadlines
- Demonstrated sense of urgency and customer-focused mindset
- Experience within the healthcare payer environment, including Medicaid and Medicare programs
- Excellent written and verbal communication skills
- Ability to influence goals and metrics across a heavily matrix organization
- Critical thinking and listening skills with strong attention to detail
- Analytical mindset with the ability to interpret complex data and make data-driven decisions to improve network adequacy
Licensure and Certification:
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
- Travel is not typically required
Compensation Range: $83,000.00 - $132,800.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type: Salary Competencies: - Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-EM1
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