LTSS Director - Planning & Strategy Lead (Strategy & Prog Dev Director)

Elevance Health; Seven Hills (OH); Hybrid; USD 100,000 - 150,000; Full time

Job summary

Elevance Health seeks an LTSS Director - Planning & Strategy Lead to provide strategic leadership for the Next Generation MyCare Ohio Program. This hybrid role involves overseeing clinical management functions, ensuring compliance, and collaborating with internal partners to enhance care coordination for LTSS members. The ideal candidate will have extensive experience in Medicaid programs and strong leadership skills.

Benefits

Comprehensive benefits

Hybrid work environment

Qualifications

• 10 years of related experience, including 5 years in leadership.
• Licensed Registered Nurse (RN) or Licensed Independent Social Worker (LISW) preferred.
• Deep knowledge of Medicaid policy and person-centered planning.

Responsibilities

• Implement and oversee clinical management functions for LTSS members.
• Monitor LTSS performance across financial, clinical, and operational KPIs.
• Develop and oversee policies in line with federal and state regulations.

Skills

Leadership

Communication

Collaboration

Regulatory Compliance

Care Coordination

Education

BA/BS in a related field

Master’s degree in a health-related field

Tools

Excel

Job description

Job Description:

Preferred Location: Ohio. This position is hybrid and requires reporting to 1 of 4 Elevance office locations at least 1-2 times per week. The ideal candidate should live within 50 miles of an Elevance Health PulsePoint location in Ohio.

Program Overview: MyCare Ohio Plan aims to deliver high-quality, trauma-informed, culturally competent, person-centered coordination addressing physical health, behavioral health, long-term services and supports, and psychosocial needs.

Position Overview: The LTSS Director - Planning & Strategy Lead provides strategic leadership for the Next Generation MyCare Ohio Program, ensuring growth and compliance through collaboration with internal partners.

Impact Responsibilities:

1. Implement and oversee clinical management functions for LTSS members, including assessments, service planning, care coordination, transition planning, member appeals, state hearings, and education.
2. Monitor LTSS performance across financial, clinical, network, and operational KPIs, integrating new regulatory requirements.
3. Lead care coordination and provider relations to execute initiatives and ensure compliance.
4. Manage provider functions including enrollment, orientation, monitoring, and incident response systems.
5. Develop and oversee policies, procedures, and protocols in line with federal and state regulations, including member grievance processes.
6. Collaborate with Medical Officers, Quality Directors, and providers to improve coordination and engagement with community partners.
7. Build relationships to enhance collaboration and satisfaction with the OH MyCare Program.

Minimum Requirements:

• BA/BS in a related field and at least 10 years of related experience, including 5 years in leadership; or equivalent education and experience.

Preferred Skills and Experience:

• Licensed Registered Nurse (RN) or Licensed Independent Social Worker (LISW) in Ohio preferred.
• Master’s degree in a health-related field with 5+ years leading Medicaid programs supporting LTSS populations, especially in Ohio.
• Deep knowledge of Medicaid policy, person-centered planning, transitions of care, network development, value-based payments, and quality monitoring.
• Experience working across different lines of business.
• Excellent presentation skills for conveying complex information clearly.
• Proficiency in Excel at an intermediate to advanced level preferred.

Additional Details:

• Job Level: Director Equivalent
• Work Shift: 1st Shift (United States)
• Job Family: Strategy, Planning & Execution

Elevance Health is committed to diversity and equal opportunity, requiring vaccination for certain roles, and offers comprehensive benefits. The organization supports a hybrid work environment and adheres to all applicable legal requirements regarding employment and accommodations.