Director Provider Network Management Long Term Services & Support

Responsibilities

• Network Strategy and Oversight: Accountable for the development and execution of strategic planning for LTSS and HCBS network development and management. Lead the development and execution of the LTSS/HCBS network strategy to ensure sufficient provider capacity, participant access, geographic coverage, service availability, and compliance with CHC program requirements.
• Provider Contracting and Negotiations: Oversee LTSS/HCBS provider contracting strategy, including contract development, rate negotiations, contract amendments, provider terminations, new provider onboarding, and value-based payments (VBP).
• Regulatory and Compliance Alignment: Ensure providers receive timely guidance regarding contractual requirements, claims processes, authorization protocols, Electronic Visit Verification (EVV) expectations, quality initiatives, and regulatory changes. Ensure the LTSS/HCBS provider network meets all applicable state, contractual, and internal network adequacy standards.
• Provider Engagement, Relationship Management, and Performance Management: Build and maintain effective relationships with LTSS/HCBS providers, provider associations, community organizations, advocacy groups, and state partners. Lead provider engagement strategies that promote transparency, responsiveness, operational clarity, and shared accountability for participant outcomes.
• Team Leadership and Talent Development: Foster team engagement and growth through consistent coaching, mentorship, and performance evaluations, supporting career development while addressing performance gaps in a timely and effective manner. Responsible for departmental staffing decisions and providing supervision to assigned staff, writes and performs annual reviews, and monitors performance issues as they arise.

Qualifications

• Bachelor’s degree (or equivalent experience) in Business or health related disciplines such as Healthcare Administration or Healthcare management or equivalent business experience.
• 8 to 10 years of progressive business management.
• 5 to 10 years Managed Care industry experience including contracting and reimbursement experience.
• 5 or more years people management experience, managing teams and project management.
• 3 years Medicaid and long term services and support (LTSS) and home and community based service (HCBS) experience required; new program implementation experience preferred; knowledge base of Medicare crossover claims set up and oversight required.

Skills

• Strong leadership and interpersonal skills.
• Excellent communication and negotiation skills.
• Ability to manage multiple projects and meet deadlines.
• Knowledge of Medicaid and long term services and support (LTSS) and home and community based service (HCBS) regulations and best practices.

Benefits

• Flexible work solutions including remote options, hybrid work schedules.
• Competitive pay.
• Paid time off including holidays and volunteer events.
• Health insurance coverage for you and your dependents on Day 1.
• 401(k).
• Tuition reimbursement.

Pay

• Salary range: $90,000 - $120,000 annually.

Schedule

• Remote with required travel to Harrisburg, PA and Ellis Preserve offices on a regular basis. Must be able to accommodate working during Eastern Time Zone.