Star Plus Senior Director Health Services

3 weeks ago

Houston, United States Community Health Choice Full time

Essential Functions

This position shall ensure that LTSS staff are trained, knowledgeable and adhere to the requirements of the state of Texas, to include HCBS Waivers, guidelines, rules and requirements, CFC (Community First Choice), Money Follows the Person Program, and Nursing Facility standards.


Promote a clear vision aligned with company values and direction¿ set SMART goals and achievable objective. Motivate and empower staff to balance member needs while being a good steward of the financial budget. Challenging and motivating the team to create quality products, services, and solutions.


Implements and monitors the business plan and oversees any implementations or business transitions impacting service operations. Develop and manage clinical operations focused on improving clinical and financial outcomes, member engagement, and satisfaction.


Develop and implement staffing models that are consistent, cost effective, and compliant with contractual obligations. Lead recruitment and operating model development to meet operational growth needs. Foster an environment that supports professional development, mobility, and operational excellence.


Develop, implement, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Community Health Choice strategies, policies, and programs.


Develop, implement, and evaluate policies and procedures, which meet business needs (may cross multiple business functions). Direct enhancements to business processes, policies, and infrastructure to improve operational efficiencies.


Ability to develop business cases for new staffing investments and work with finance to secure funding when additional staff are warranted.


Ability to develop, evaluate and articulate current status, planning, and strategic initiatives via executive level presentations and able to speak professionally to Executive Level audience.


Ability to successfully motivate, drive and lead colleagues in Manager, Supervisory and field level positions.


Ability to interpret State contract to ensure Community Health Choice is performing to contract expectations.


Skilled in managing people, conflict resolution, ability to influence success at all levels including non-clinical staff.


Collaborate and partner with HHSC and all regulatory agencies to ensure CHC is meeting all obligations and reports are submitted timely.


Partner with Quality and Compliance to ensure URAQ and NCQA standards are met.


Develop and participate in presentations to governing entities. Participate in internal and external health industry development efforts.


Marginal Functions


Prepare concise ad clear documents and presentation for Executive Leadership


Actively contributes to achievement of departmental goals, as identified in Department¿s annual business plan, including specific departmental process improvement plans, and other duties as assigned.



QUALIFICATIONS:


Education/Specialized Training/Licensure:

Licensed RN in the state of TX or compact license required.


BSN


Masters Degree preferred.




Work Experience (Years and Area):

3 -5 years of experience working in Medicaid Long Term Services & Supports (LTSS), and/or experience with care management.


Experience with Waiver and HBCS programs.


Experience with data-driven program management.


Experience working with a government program.



Management Experience (Years and Area):

5-7 years of experience in a Senior Manager, or Director role managing large teams of 75+ employees

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