Description

Director, Care Management

Location: Multi-state (Remote/Hybrid options available)

Make an Impact at the Crossroads of Clinical Strategy and Innovation

We’re seeking a transformational healthcare leader to drive care management strategy across the continuum — from inpatient transitions to high-touch ambulatory care. This is your opportunity to lead large-scale care coordination initiatives that improve outcomes, reduce cost, and bring meaningful change to medically complex populations.

If you're a licensed RN or clinical professional with deep experience in utilization management, post-acute care, and managed care operations, this role was built for you.

About the Role

As Director of Care Management, you’ll oversee clinical and operational excellence across multi-state programs, supporting Medicaid, Medicare Advantage, and SNP populations. You'll champion transitions-of-care quality, compliance, and technology-driven care models, collaborating cross-functionally with providers, payers, and operational stakeholders.

What You’ll Lead

• End-to-end care management strategy — including Models of Care, Transitions of Care, Chronic Disease Management, and High-Risk Concierge Programs.
• Day-to-day department leadership for care managers, care coordinators, and social workers across acute, post-acute, and ambulatory care.
• Strategic expansion of care management services across multiple states and health plans.
• Integration of technology platforms and analytics tools to support real-time workflows and operational efficiency.
• Collaborative partnerships with clinical, IT, quality, and community teams to ensure seamless patient care journeys.
• Budget oversight, staffing, policy development, and performance improvement initiatives aligned with enterprise goals.

Qualifications

Licensure & Education

• Active RN license or relevant clinical license.
• BSN, LMSW, LCSW or equivalent required. Master’s in Nursing, Healthcare Administration, or MBA preferred.
• CCM (Certified Case Manager) or equivalent preferred.

Experience

• 8+ years in care management, utilization review, or clinical operations.
• 3+ years in healthcare leadership, ideally within health systems or managed care.
• Proven success managing transitions of care, discharge planning, and strategic population health programs.
• Experience scaling programs across geographies and payer models.

Skills

• Strong clinical judgment, financial and regulatory acumen.
• Comfortable navigating CMS guidelines (SNP, RADV, MOC, TOC metrics).
• Skilled at coaching, cross-functional collaboration, and operational change.
• Proficiency in leveraging data and dashboards to drive performance.

Why This Role

• Mission-driven work supporting high-risk and underserved populations.
• Strategic seat at the table in enterprise-level transformation.
• Opportunity to innovate across states, technology platforms, and care settings.
• A chance to lead and mentor a multidisciplinary team of impact-focused professionals.

Ready to Elevate Care?

This is more than a leadership role — it’s a career move with purpose.
If you’re passionate about improving lives through better systems, smarter care transitions, and empowered clinical teams, we want to hear from you.

Apply now and bring your vision to life in a role where strategy meets compassion. directorcaremanagement2025@gmail.com