Care Management Director

Position Summary

We are seeking an experienced and compassionate Director of Care Management to lead and oversee the daily operations, strategic development, and quality performance of our chronic care management and behavioral health integration services. This leadership role is responsible for ensuring high-quality, patient-centered care coordination while driving operational efficiency, compliance, and positive clinical outcomes.

The ideal candidate is a strong clinical leader with experience in care management, utilization review, and interdisciplinary team leadership.

Key Responsibilities

• Provide leadership and oversight for all care management program operations
• Develop and implement strategies to improve patient outcomes, reduce readmissions, and enhance care transitions
• Supervise and train care management staff
• Monitor quality metrics, KPIs, and regulatory compliance standards
• Collaborate with providers, administration, and interdisciplinary teams to improve coordination of care
• Oversee utilization management, care planning, and resource coordination processes
• Conduct program evaluations and identify opportunities for workflow and performance improvement
• Ensure accurate documentation and compliance with organizational, state, and federal requirements
• Assist with policy development, staff education, and process standardization

Qualifications

• Registered Nurse (RN) required; BSN preferred
• Minimum 5 years of care management in hospital, outpatient, behavioral health, or multi-site healthcare settings
• Minimum 2 years of leadership or supervisory experience
• Strong knowledge of healthcare regulations, utilization review, discharge planning, and quality improvement
• Experience with EMR systems and healthcare documentation standards
• Excellent communication, leadership, organizational, and problem-solving skills
• CCM or ACM certification a plus