Senior Director, LTSS and Dual Growth Strategy(Preferred Experience with DSNP, HIDE & FIDE)

Job Summary:

The Senior Director, LTSS and Dual Growth Strategy is responsible for leading and fostering strategic and operational expertise partners to develop and implement solutions to promote duals/LTSS products growth.

Essential Functions:

• Serve as Duals/LTSS products SME and partner liaison for all strategic and operational relationships targeted for product growth partnership programs and models
• Collaborate with executive leadership to establish and deploy an innovative, best- in-class growth model capable of scaling for all markets
• Assist leadership in the design and development of innovation deployment strategy, including project deployment and prioritization
• Lead cross-functional strategies to optimize health plan profitability by managing multiple financial and operational levers, including rate advocacy, risk adjustment, member growth and retention, medical cost management, Star performance, and Medicaid Quality metrics
• Set and drive enterprise-level strategies to increase market share across the region, leveraging competitive intelligence, network optimization, and differentiated service offerings to position the plan as a market leader
• Design and implement comprehensive, market-specific growth strategies and KPIs that align with enterprise objectives, with a focus on long-term sustainability, profitability, and member outcomes
• Direct financial planning and performance management through oversight of monthly and quarterly forecasts, variance analysis, and departmental P&L reviews, ensuring alignment with both short- and long-term financial targets
• Provide executive-level leadership over financial and operational reporting to inform strategic decisions, partnering with Finance, Actuarial, Clinical Operations, and Compliance to identify risks, forecast trends, and ensure accountability to business goals
• Serve as interface between partners and CareSource teams supporting the partnership program including sales, community outreach, care management etc.
• Provide oversight of all teams, internal and external to CareSource, managing the Duals/LTSS programs
• Collaborate with marketing team to develop product materials for distribution to community and provider partners
• Ensure operational readiness through oversight and monitoring for process improvement opportunities
• Oversee collaboration with Enterprise teams, internal and external stakeholders, and community partners to inform and influence the design and development of Duals/LTSS programs
• Build, maintain and improve all structure and processes necessary to assure impeccable regulatory record, achievement of goals and consistency from market-to-market and product-to-product
• Lead efforts with market and product leaders to develop aligned, collaborative processes designed to meet the business requirements and goals of Duals/LTSS in the designated market
• Oversee implementation of all community and retail partnerships solutions
• Monitor, report, and evaluate performance metrics to improve functionality and efficiency
• Travel as needed to conduct meetings and ensure effective administration of the program
• Perform any other job duties as requested

Education and Experience:

• Bachelor of Science/Arts (BS/BA) degree in business, communications, marketing, or related field, or equivalent relevant work experience is required
• Master of Business Administration (MBA) or Public Health (MPH) is preferred
• A minimum of five (5) years of managed care experience is required
• A minimum of three (3) years of consumerism experience is required
• Previous experience working with community-based and/or retail organizations to develop partnerships is preferred

Competencies, Knowledge, and Skills:

• Demonstrated understanding duals/LTSS programs including development and operations required
• Ability to manage and prioritize multiple tasks, promote teamwork and fact-based decision making
• Business acumen and strategic thinking, yet able to execute tactically
• Demonstrated ability to adjust to shifting priorities, multi-task, work under pressure and meet deadlines
• Proven ability to recognize opportunity for improvement and lead change
• Excellent leadership and communication skills, with ability to effectively manage a high performing team, and provide coaching and development
• Strong collaborative skills, working with cross-functional stakeholders and external partners
• Ability to represent CareSource in national and community partnership

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Some travel may be required to fulfill the duties of the role

Compensation Range:

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 (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business