Manager, LTSS Service Determination Operations
About this role
Job Summary
The Manager, LTSS Service Determination Operations is responsible for leading the day-to-day operations of a market specific LTSS service determination function, ensuring accurate, timely, and compliant translation of assessments into appropriate long-term services and supports (LTSS), ensuring decisions are member-centered, operationally executable, and aligned with regulatory and cost-of-care objectives.
Essential Functions
- Serve as the primary operational lead for LTSS service determinations within an assigned market(s), ensuring alignment with state-specific program rules, waiver requirements, contractual obligations, and workflow nuances. Act as the key market-level liaison for LTSS service determinations, partnering with local Care Management, Clinical, Product, and Compliance stakeholders to ensure operational readiness and issue resolution.
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