Director of Care Management
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Job Description
Director of Care Management leading centralized team for Medicare seniors' healthcare. Focusing on care coordination, chronic disease management, and operational excellence.
Responsibilities:
- Lead and develop a high-performing care management organization supporting Medicare members with multiple chronic conditions.
- Drive consistent care plan execution, follow-up, and care coordination across the member population.
- Build and maintain operational structure: workflows, SOPs, escalation pathways, training standards, and performance management.
- Optimize care management workflows to support strong clinical outcomes while ensuring documentation quality, compliance, and accurate reimbursement.
- Partner closely with the Medical Director to ensure care management work is clinically aligned.
- Work cross-functionally with Billing/RCM, Clinical Ops, and Product/EHR teams to ensure care management work is well-documented, trackable, and operationally efficient.
- Establish and run quality assurance processes (audits, coaching loops, documentation standards, member experience reviews).
- Hire, coach, and retain strong frontline care management leaders and team members.
Requirements:
- 5+ years in healthcare operations, care management, clinical program leadership, or related fields
- 3+ years managing teams with measurable performance expectations
- Experience supporting Medicare populations
- Strong understanding of care coordination, chronic disease management, and care plan execution
- Comfort operating in a fast-paced environment with real performance metrics
- Direct experience with Chronic Care Management (CCM) (strongly preferred)
- Experience in Medicare Advantage, value-based care, or a scaling provider group (strongly preferred)
- Experience partnering with a Medical Director or clinical governance leader (strongly preferred)
- Experience leading care management in a telehealth-first, virtual care, or hybrid care delivery model (strongly preferred)
- Familiarity with EHR-based workflows (eClinicalWorks a plus) (strongly preferred)
Benefits:
- Health insurance
- 401(k) matching
- Paid time off
- Flexible work hours
- Professional development opportunities
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