Supervisor, Long Term Services and Supports (LTSS)

Department(s): Long Term Care (Long Term Services and Supports)
Reports to: Manager Long Term Support Services
FLSA status: Non-Exempt
Salary Grade: N - $95,000 - $155,078

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is on Tuesday, November 21, 2023 at 11:59 PM.  Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.   

About CalOptima Health

Are you looking for a career that changes lives? As the single largest health plan in Orange County, CalOptima Health serves one in three residents with health insurance programs for low-income children, adults, seniors and people with disabilities. Our 1,500 employees are valued for their individual perspectives and contributions and benefit from flexible work schedules, recognition and opportunities to grow. If you’re looking for a rewarding career supporting a meaningful mission, along with generous benefits and recognition, consider joining us at CalOptima Health!

About the Position

The Supervisor Long Term Support Services will be responsible for planning, organizing, developing and implementing the principles, programs, policies and procedures employed in the delivery of Long Term Services and Supports (LTSS) to members in the community and institutionalized settings. The incumbent will be responsible for the management of the day-to-day operational activities for LTSS programs: Long Term Care (LTC), Community Based Adult Services (CBAS) and CalAIM (Enhanced Care Management (ECM) and Community Supports (CS)), while interacting with internal/external management staff, providers, vendors, health networks and other internal and external customers in a professional, positive and competent manner. The incumbent will be responsible supervising and monitoring the ongoing and daily activities of the department staff. In addition, the incumbent will resolve members' and providers' issues and barriers ensuring excellent customer service. The incumbent will manage staff coverage in all areas of LTSS to complete all assignments, the orienting and training of new employees and ensure contractual and regulatory requirements are met.

Duties & Responsibilities:

• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
• Supervises, trains and audits the LTSS Medical Case Managers, Social Workers, Program Specialists and non-clinical staff such as Personal Care Coordinators (PCC), Medical Authorization Assistants (MAA) and Administrative Assistants (AA) per Medi-Cal processing guidelines.
• Serves as a resource to departmental and organizational staff which includes internal departments and affiliated health networks, regarding authorization rules and processes.
• Manages the day-to-day activities of the department to ensure compliance with company policies and regulatory requirements.
• Attends all LTSS required meetings, Concurrent Review and Case Management clinical rounds and other meetings, including internal and external interdisciplinary care team meetings as needed or assigned.
• Makes staffing assignments and recommendations based on authorization priority, overall workload and staffing needs per program to ensure daily workloads are fulfilled with a cost-effective use of resources and time.
• Conducts audits as assigned by LTSS management team as required by policy and procedure, including auditing for quantity and quality of work completed and timeliness required by regulations.
• Provides on-going/periodic in-service training for all staff based on audit findings and facilitates the on-going development and education of staff.
• Provides assistance in the development and implementation of policies and procedures, as well as orientation.
• Trains, evaluates and provides performance feedback to staff as needed, including day-to-day coaching and performance feedback to individuals, annual and 90-day appraisals and Performance Improvement Plans based on individual needs; involves Human Resources as necessary.
• Identifies areas of improvement in workflows, assists in the creation of desktop procedures and new workflows for corrective action and educates the LTSS staff on new/revised workflow processes.
• Assists the Manager of LTSS in all areas of the department to ensure departmental and organizational goals are met, including the requirement to be able to complete authorization approvals for CBAS, LTC, ECM and CS programs.
• Works with the Information Technology Services (ITS) and reporting departments to support the department in the creation of reports that ensures monitoring and reporting of LTSS program activities to regulatory agencies as required by the organization and regulatory entities.
• Establishes and maintains effective working relationships with public and private agencies providing Long Term support services to members, including assisting health networks and other departments to minimize barriers to discharge planning.
• Resolves provider/vendor/member problems related to the delivery of LTSS.
• Completes other projects and duties as assigned.

Experience & Education:

• Bachelor’s degree in a Healthcare related field and a current unrestricted Registered Nurse (RN) License to practice in the State of California required.
• For non-RNs, a Master’s degree in Healthcare, Social Work or related field required.
  • 3 years of experience in a health care or managed care setting required.
• An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above is also qualifying.
• Valid driver’s license and vehicle or other approved means of transportation, an acceptable driving record and current auto insurance will be required for work away from the primary office 25% of the time or more required.

Preferred Qualifications:

• 1 year of supervisory and/or lead experience.

Physical Demands and Work Environment:

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Physical demands: While performing duties of the job, employee is required to move about the organization as well as to offsite locations. Must also be able to reach with hands and arms and must be able to lift and carry up to 25 pounds to transport a laptop and other collateral material. Employee must be able to communicate, particularly for regular phone use, face-to-face interaction and in meetings. Employee must have means of transportation for offsite travel to the CalAIM providers, PACE Center, Skilled Nursing Facilities, CBAS Centers and County Social Services Facilities approximately 25% of the time.

• Work Environment: Typical office environment with minimal to moderate noise levels and controlled office temperatures. Offsite environment is equivalent to a medical facility.

About our Benefits & Wellness options:

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. Employees also have access to 457(b) retirement plans with pre/post-tax contribution options. 

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

CalOptima Health is an equal employment opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.