LTSS Medicaid Operations Director – Remote at UnitedHealth Group

Clipped from:

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

This subject matter expert role will provide insights into long term care services (LTSS) operational complexity to support of fully/partially integrated programs. This leadership role supports product fluidity to comply with CMS guidance directing payers to prepare to have fully integrated Medicare/Medicaid capabilities going forward.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:


  • Provide program operational and regulatory expertise for LTSS/HCBS integrated services including but not limited to assessment, service planning, care coordination, transition planning, consumer hearings, member and caregiver education and training, compliance with program requirements, rules, and regulation
  • Partner with provider relations team to develop content to support provider management functions for Providers of HCBS services including but not limited Support content for program policies procedures and protocols that are aligned with federal and state requirements and community education program
  • Contribute to strategies which foster best in class service to the Health Plan, State Department of Medicaid, CMS and Corporate
  • Contribute to the operational strategic vision, objectives, policies, and procedures related to LTSS/HCBS
  • Identify operational efficiencies; meet regulatory and corporate expectations and develop a “best practice” approach to the defined operational areas
  • Identifies tactics to meet and exceed requirements including organizational, state, accreditation, compliance, and contractual agreements
  • Assess program strengths and weaknesses to recommend and deliver enhanced operating model
  • Participate in business development and membership growth including procurement and re-procurement activities

You’re ready to take on an incredibly challenging marketplace of ideas, products, and services. But are you up for leading the transformation of an entire industry? Here, you’ll work with the smartest people on solving the most important problems our nation is facing. The tasks are huge, the impact is far-reaching -it’s the best chance to test your mettle on a global stage.

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:


  • Undergraduate degree or equivalent experience
  • 5+ years of experience with managed healthcare, preferably in Medicaid ABD, LTSS and/or Medicare
  • Demonstrated exceptional verbal (e.g., Public Speaking) Writing /Composing: Correspondence /Reports Analytical, MS Word, MS Excel

Preferred Qualification:


  • 3+ years management experience

Already Fortune 5, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we’re doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we’re building a high-performance health care system that works better for more people in more ways than ever. Now we’re looking to reinforce our team with people who are decisive, brilliant – and built for speed.

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $118,000 to $226,800. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.