Director, Care Management - Foster Care

Directs the care management team and the care of members to develop and assess high-quality, cost-effective healthcare outcomes. Develops strategies and objectives within care management to improve member and/or provider experience.

Responsibilities

• Must reside within Oklahoma or be willing to relocate; onsite meetings at the Oklahoma City office.
• Directs and evaluates departmental operations, including the care management model, staffing, use of information technologies, and staff competencies to achieve performance and quality objectives.
• Oversees care management team on performance, improvement, and talent management.
• Sets goals and objectives for the care management team and oversees care management data and reporting metrics to achieve quality and cost-effective healthcare results; collaborates with senior leadership as required.
• Provides oversight of the development and implementation of care management policies and procedures to ensure compliance with regulatory requirements for federal, state, and National Committee for Quality Assurance (NCQA) standards.
• Stays up to date on latest trends and best practices in Payer Care Management and related fields; attends conferences as required.
• Leads process improvements for the care management team to achieve quality and cost-effective healthcare results; collaborates with senior leadership as required.
• Contributes to the development and improvement of clinical care pathways that enhance cost-effectiveness while providing quality care.
• Develops care management strategies and influences decisions by providing recommendations that align with organizational objectives.
• Develops department budget in collaboration with other departments and senior leadership.
• Develops the overall strategy for onboarding, hiring, and training new care management team members to ensure adequate training, high-quality care, and compliance.
• Performs other duties as assigned.

Requirements

• Requires a Bachelor's degree and 7+ years of related experience, including prior management experience. Equivalent experience acquired through applicable knowledge, duties, scope, and skill may substitute for the degree.
• For Oklahoma Complete Health: Oklahoma Registered Nurse (RN) license or Compact Registered Nurse (RN) license and nationally recognized case management certification required.

Pay

$121,500.00 - $224,900.00 per year. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives.

Benefits

• Competitive pay.
• Health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible approach to work with remote, hybrid, field, or office work schedules.