Director, Care Management

Direct the care management team and member care to develop high-quality, cost-effective healthcare outcomes and improve member/provider experiences. Oversee departmental operations, including the care management model, staffing, information technologies, and staff competencies to achieve performance and quality objectives. Set goals and objectives for the team, oversee data and reporting metrics, and lead process improvements while ensuring compliance with federal, state, and NCQA standards. Develop department budgets, implement policies and procedures, and contribute to clinical care pathways that enhance cost effectiveness. Lead the strategy for onboarding, hiring, and training new team members to ensure adequate training and high-quality care.