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 Here: https://www.click2apply.net/djyrjpFOY5a4jcQ61U2rpb
PI279818847

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