Dir, MLTSS Operations

About the role

This role is responsible for the strategic leadership, performance oversight, and operational execution of the Managed Long-Term Services and Supports (MLTSS) program. It ensures the delivery of high-quality, compliant, and member-centered services across home- and community-based care, as well as facility-based settings (e.g., nursing homes and assisted living facilities). The role partners cross-functionally with internal stakeholders and external providers to drive program effectiveness, maintain regulatory compliance, and optimize member outcomes, while leading a high-performing operations team that supports care management delivery.

Responsibilities

• Develop and execute the strategic direction for MLTSS Operations aligned with Government Programs and enterprise priorities.
• Ensure delivery of high-quality, cost-effective, and member-centric services across the MLTSS continuum.
• Drive continuous improvement initiatives to enhance service delivery, operational efficiency, and member satisfaction.
• Ensure full compliance with NJ MLTSS contract requirements, state and federal regulations, and accreditation standards.
• Oversee program audits, readiness activities, and corrective action plans.
• Develop and maintain policies and procedures aligned with regulatory requirements.
• Oversee care coordination activities across multiple care settings to ensure seamless member experiences.
• Serve as the primary point of contact for Provider Contracting and Network teams to maintain an adequate and high-performing LTCSS network.
• Collaborate with internal stakeholders (Medical Economics, Clinical, Compliance, Analytics) and external partners to drive program outcomes.
• Represent MLTSS Operations in enterprise and regulatory workgroups.
• Leverage data insights to monitor program performance, identify trends, and drive evidence-based decision-making.
• Collaborate with analytics teams to develop reporting on population health outcomes and operational performance.
• Identify operational risks and implement mitigation and process improvement strategies.
• Lead, develop, and retain a high-performing team, fostering a culture of accountability, collaboration, and continuous learning.
• Oversee staff training, development, and performance management processes.
• Audit workforce capabilities and implement targeted learning and development initiatives.

Requirements

• High School Diploma/GED required.
• Bachelor’s degree in Healthcare Administration, Nursing, Public Health, or related field preferred.
• 7–10+ years of progressive leadership experience in managed care, long-term services and supports, or healthcare operations.
• Demonstrated experience leading complex, regulated programs (Medicaid/MLTSS strongly preferred).
• Experience managing cross-functional teams and driving enterprise initiatives.

Qualifications

• Deep understanding of MLTSS programs, home and community-based services, and long-term care delivery models.
• Strong knowledge of regulatory and compliance requirements.
• Strategic thinking and execution capabilities.
• Data-driven decision-making and performance management.
• Executive-level communication and stakeholder management.
• Change leadership and continuous improvement mindset.

Skills & Competencies

• Strategic thinking and execution capabilities.
• Data-driven decision-making and performance management.
• Executive-level communication and stakeholder management.
• Change leadership and continuous improvement mindset.

People Leadership & Talent Development

• Lead, develop, and retain a high-performing team, fostering a culture of accountability, collaboration, and continuous learning.
• Oversee staff training, development, and performance management processes.
• Audit workforce capabilities and implement targeted learning and development initiatives.

Disclaimer

This description is intended to describe the general scope and level of work performed and is not an exhaustive list of all responsibilities, duties, or qualifications. The salary range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This range has been created in good faith based on information known to Horizon at the time of posting. Compensation decisions are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes: Comprehensive health benefits (Medical/Dental/Vision)Retirement PlansGenerous PTOIncentive PlansWellness ProgramsPaid Volunteer Time OffTuition Reimbursement. Horizon is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the recruiting and hiring process.