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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in leading Long-Term Services and Supports (LTSS) and Home and Community-Based Services (HCBS) programs, with a strong focus on compliance, strategic partnerships, and program effectiveness. Possesses advanced skills in healthcare management, policy development, and budget oversight within the context of health insurance and managed care.
Highest-signal resume keywords
LTSS Program ManagementHealth Insurance ExperienceStrategic Partnership DevelopmentRegulatory ComplianceAnalytical Problem-Solving
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Program DesignPolicy DevelopmentBudget ManagementCare Management KnowledgeHealthcare RegulationsService CoordinationService IntegrationContract ReportingChange ManagementLong-Term Care Services
Soft Skills
Effective CommunicationCritical ThinkingDecision-MakingProblem-SolvingLeadership
Certifications & Qualifications
Master's Degree in HealthcareMaster's Degree in NursingMaster's Degree in Social WorkMaster's Degree in Public Administration
Industry Keywords
Community HealthChoicesPerson-Centered PhilosophySelf-DeterminationDisability ServicesOlder Adult ServicesManaged CareHealthcare LawsState RegulationsAdvocacy GroupsMultidisciplinary Teams
About the role
Key responsibilities & impact- Lead strategy, program design, and implementation for all LTSS/HCBS requirements and functions of the Community HealthChoices agreement
- Lead and implement Geisinger Health Plan’s Community HealthChoices program, including Service Coordination and Service Integration
- Develop and oversee strategic partnerships with LTSS providers, community organizations, advocacy groups, associations, vendors, and others
- Represent Geisinger Health Plan as its CHC leader and LTSS subject matter expert in state forums
- Prepare the plan for CHC readiness reviews and routine audits
- Monitor, review, and sign off on contract-required reporting
- Develop policies and procedures for effective and efficient delivery of LTSS programs and services
- Assess program effectiveness and participant experience and implement improvements
- Collaborate with leadership on operational issues, staffing, resources, systems, and program needs
- Present solution action plans for issues
- Facilitate and participate in committees, task forces, work groups, and multidisciplinary teams
- Ensure compliance with state and federal regulations and CHC contractual obligations
- Develop and manage budgets for CHC functions and costs
- Monitor industry trends, innovations, healthcare laws, and regulations and adjust programs and services accordingly
Requirements
What you’ll need- Must live in Pennsylvania
- Frequent travel to locations across Pennsylvania, including State meetings
- Master's Degree required in Healthcare, Nursing, Social Work, Public Administration, or related field
- Understanding of long-term care services and supports policies, practices, and regulations
- Minimum of 8 years of managerial/supervisory experience
- Minimum of 5 years of health insurance/managed care experience
- Familiarity with person-centered philosophies, concepts of independence, and/or self-determination
- Experience working with individuals with disabilities and older adults
- Strong analytical skills
- Effective problem-solving and change management skills
- Ability to function well independently in a busy environment
- Excellent verbal and written communication skills
- Effective critical thinking and decision-making skills
- Skills in care management knowledge, health insurance, leadership, organizing, communication, and decisive action
Benefits
Comp & perks- Healthcare benefits for full-time and part-time positions from day one
- Vision benefits
- Dental benefits
- Domestic partner benefits
- Collaborative, cooperative, and collegial work atmosphere