Become a part of our caring community and help us put health first
 

Humana Healthy Horizons is seeking a Director, Long-Term Supports and Services (LTSS) Strategy who will oversee day-to-day operations of the Medicaid Program Transformation, LTSS program, implementing strategic plans and fostering key relationships with stakeholders. This role will promote intradepartmental and cross market coordination, data and trend analysis, and quality improvements, establishing long range goals, objectives, and plans that evolve along with Medicaid’s strategic priorities and the needs of members, providers, and regulatory partners.

Position Responsibilities:

• When given National Medicaid Strategic Priorities, develops and executes LTSS strategies to drive sustainable and profitable growth and improve health outcomes.  
•  Support strategic goals and turn those goals into specific operating and business plans that are executed in partnership with Market Teams. 
• Deliver value to new markets by leading development of LTSS business infrastructure to include staffing models, job descriptions, program descriptions, policies and procedures, audit tools, training content, and more as needed to support implementation of successful LTSS operations.  
• Drive standardization of LTSS best practices and capabilities across markets.  
• Develop and maintain reporting mechanisms to track, trend, and monitor success of the LTSS programs across states and effectiveness of LTSS initiatives. 
• Lead end-to-end deployment of LTSS capabilities including: 
  • Participation and key SME input to develop national and market staffing models. 
  • Vendor selection, development of operating model, oversight of implementation and ongoing monitoring.  
  • Support community partnership deployment including innovative models with AAAs and CILs to bring the strongest programmatic support to members and caregivers. 
• Lead strategic guidance for the build and oversight of a national utilization model to drive effective and efficient use of LTSS services which are both person-centered and strength-based, empowering members to be independent through the removal of barriers and the prioritization of community engagement.  
• Develop effective strategies supporting grievance, appeals, and fair hearings into overall LTSS Operating Model.  
• Lead and influence functional partners by fostering collaborative partnerships. 
• Influence and negotiate effectively to arrive at win-win solutions. 
• Communicate and present effectively, listen actively and attentively to others, and convey genuine interest. 
• Ability to lead by example and hold employees accountable to complete the tasks they are assigned and to perform the duties of their jobs. 
• Own execution of daily operating objectives and goals, including key performance metrics or Objectives and Key Results. 
• Lead change and innovation by demonstrating emotional resilience, managing change by proactively communicating the case for change and promoting a culture that thrives on change. 
• Effectively represent the Medicaid Program Transformation (MPT), LTSS team in discussions/processes within and external to Humana.  
• Demonstrate servant leadership skills and emotional intelligence skills.  
• Personal accountability and commitment to continuously improve the associate experience. 
• Plan departmental growth and potential staff successions; enable succession through the investment in team culture, learning and development. 

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s degree in Gerontology, Sociology, Nursing, Public Health, or another related field plus work experience of three (3) to five (5) years leading or operating a managed long term care or LTSS program OR five (5) to seven (7) years of prior experience leading or operating a managed long term care or LTSS program.
• Experience in strategic and thought leadership in supporting Medicaid health plans. 
• Three (3) years of experience directly leading teams and departmental activities to ensure accurate and timely accounting, financial and statistical reports. 

Preferred Qualifications

• Two (2) years of experience leading integrated LTSS programs such as PACE, FIDE SNP, or other similar models. 
• MBA, MHA or equivalent. 
• Experience in process improvement - Six Sigma/Lean Concepts. 

Additional Information

• Workstyle: Home. Home workstyle is defined as remote but will use Humana office space on an as needed basis for collaboration and other face-to-face needs.
• Travel: up to 20% travel will be required.
• Typical Work Days/Hours: must be available to work Monday – Friday, 8 am – 5 pm Eastern Standard Time zone (EST