Director Clinical Health Services LTSS Aetna New Albany

Job Description
Oversees ILTCM and LTSS. Interfaces regularly with regional Area Agencies on Aging and regional long term care facilities.

The Primary Functions Of The LTSS/HCBS Director Are

Implementation and oversight of all clinical management functions for members receiving LTSS including but not limited to: assessment, service planning, care coordination, transition planning, member hearings, member and caregiver education and training
Oversight of all Provider management functions for Providers of HCBS services including but not limited to: Provider Enrollment, orientations and monitoring
Ensures compliance with program requirements; management of policies and procedures aligned with state and federal requirements
Coordinates and prepares team for State and federal audits
· Oversight of reporting requirements and submission for LTSS/HCBS

Fundamental Components

Must have experience in LTSS. Must possess working knowledge about local Area Agencies on Aging.

BACKGROUND/EXPERIENCE Desired

Either an RN licensed in the state of Ohio or a Licensed Independent Social Worker (LISW) is required. A Master’s degree in a health-related field is desired. At least five (5) years of experience in home and community based services preferred.

EDUCATION

The highest level of education desired for candidates in this position is a Master’s degree or equivalent experience.

LICENSES AND CERTIFICATIONS

Nursing/Nursing License and/or license in independent social work (LISW) is required.

FUNCTIONAL EXPERIENCES

Functional - Nursing/Case Management/4-6 Years
Functional - Leadership//1-3 Years