Manager, MSHO/MSC+ Comprehensive Care Advocacy

HealthPartners is seeking a MSHO/MSC+ Manager, HealthPartners Comprehensive Care Advocacy to provide leadership, strategic direction, and operational oversight for care coordination programs serving Medicare and Medicaid populations for our MSHO and MSC+ members.  This role is responsible for ensuring high-quality, member-centered care coordination services, assessment operations, regulatory compliance, quality outcomes, and staff development.

The Manager partners with internal teams, providers, community organizations, and delegated entities to improve member experience, health outcomes, affordability, and program performance while ensuring compliance with state and federal requirements.

Primary Responsibilities

Leadership & Staff Development

• Provide leadership, coaching, and performance management for supervisors and care coordination staff.
• Support workforce planning, staff development, succession planning, and employee engagement.
• Foster a culture of accountability, collaboration, innovation, and continuous improvement.

Program Oversight

• Oversee care coordination programs serving Medicare and Medicaid members, including MSHO, MSC+, waiver, and long-term services and supports populations.
• Ensure delivery of member-centered care coordination services that meet contractual, regulatory, and organizational requirements.
• Lead implementation of strategic initiatives, program enhancements, and operational improvements.

Assessment Operations

• Provide oversight of MnChoices assessment activities.
• Ensure assessment practices meet DHS, CMS, and organizational requirements.
• Support assessment quality, consistency, training, and process improvement efforts.

Quality, Compliance & Performance Management

• Monitor key performance indicators, quality measures, audit results, and operational outcomes.
• Lead quality improvement initiatives and corrective action efforts as needed.
• Ensure compliance with Medicare, Medicaid, DHS, CMS, and organizational requirements.
• Develop and maintain policies, procedures, and operational standards.

Delegate & Partner Oversight

• Provide oversight of delegated care coordination entities and contracted partners.
• Monitor performance, quality outcomes, compliance, and member experience metrics.
• Collaborate with internal and external stakeholders to drive program improvements and achieve performance goals.

Collaboration & Communication

• Build strong partnerships across HealthPartners, provider organizations, community agencies, and delegated partners.
• Communicate effectively with staff, leadership, providers, members, and external stakeholders.
• Serve as a clinical and operational resource for complex member and program issues.

Required Qualifications

• Bachelor's degree in Nursing, Social Work, or another healthcare-related field.
• Current Minnesota licensure as a Registered Nurse (RN) or Social Worker.
• Current MnCHOICES Certified Assessor certification.
• Minimum of five (5) years of experience in care coordination, case management, long-term services and supports, managed care, or a related healthcare field.
• Minimum of five (5) years of leadership or management experience.
• Demonstrated knowledge of Medicare, Medicaid, DHS, CMS, waiver programs, and long-term services and supports.
• Experience leading teams, managing program operations, and driving quality and performance outcomes.
• Strong analytical, communication, project management, and relationship-building skills.

Preferred Qualifications

• Recent experience with MSHO, MSC+, Elderly Waiver, and other Minnesota public programs.
• Experience overseeing assessment operations and care coordination teams.
• Experience with delegated care coordination oversight and vendor management.
• Master's degree in Nursing, Social Work, Public Health, Healthcare Administration, or a related field.

DECISION-MAKING: 

Makes independent decisions within the scope of this position’s accountabilities and determines the need for and the timing of consultation with senior leadership and/or medical director. 

• Common areas of focus:
• Program-specific processes
• Program-specific Policies and Procedures
• Program design
• Strategic initiative execution