General Manager Integrated Care Management
Essen Health Care · Bronx, NY · 3 wk ago
ManagementFull-time
About the role
The General Manager, Integrated Care Management Model is responsible for the operational leadership, performance management, and scalable execution of Intention Healthcare’s integrated care management model. This role oversees a team of Care Management & RPM Supervisors who each manage provider pods and Integrated Care Coordinators supporting attributed patient panels.
Responsibilities
- Lead the day-to-day operations of the integrated care model across CCM, APCM, PIN, CHI, BHI, and RPM.
- Ensure supervisors execute consistently across assigned provider pods and patient panels.
- Translate organizational goals into clear operational targets for supervisors and Integrated Care Coordinators.
- Build scalable workflows that support growth in enrollment, billing capture, patient engagement, and quality performance.
- Identify operational risks, workflow gaps, and execution barriers that may impact performance, compliance, or revenue.
- Directly oversee Care Management & RPM Supervisors responsible for provider pods and care coordinator teams.
- Set clear expectations for supervisor performance, including enrollment growth, productivity management, documentation quality, provider responsiveness, and staff accountability.
- Review supervisor dashboards and pod-level performance trends on a daily, weekly, and monthly basis.
- Coach supervisors on workload management, staff performance, escalation handling, and provider communication.
- Conduct regular performance reviews and implement corrective action plans when operational targets are not met.
- Develop supervisors into stronger operational leaders capable of managing larger panels and more complex workflows.
- Own performance across assigned patient panels, provider pods, and care management programs.
- Drive enrollment growth across eligible patients for CCM, APCM, PIN, CHI, BHI, and RPM.
- Monitor panel penetration rates, patient outreach outcomes, consent capture, activation rates, and program participation.
- Ensure supervisors are actively managing enrollment opportunities and addressing barriers to growth.
- Partner with providers and clinical leadership to increase the adoption of care management programs.
- Use data to identify underperforming pods, missed enrollment opportunities, and patient engagement gaps.
- Ensure Integrated Care Coordinators meet program-specific productivity, documentation, and time thresholds.
- Monitor completion rates, monthly activity capture, billing readiness, and documentation of quality across all care management programs.
- Ensure workflows support compliance with CMS requirements, payer rules, internal documentation standards, and audit readiness.
- Partner with Revenue Cycle, Compliance, Analytics, and Product teams to improve billing capture and reduce preventable denials.
- Create accountability systems to ensure supervisors address performance gaps quickly and consistently.
- Ensure supervisors serve as effective operational liaisons to assigned providers.
- Monitor provider satisfaction, provider responsiveness, workflow escalations, and unresolved operational issues.
- Standardize communication between supervisors, providers, care coordinators, and centralized support teams.
- Resolve escalated provider concerns related to care management workflows, RPM, referrals, DME, lab/imaging follow-up, patient outreach, and panel support.
- Create a provider-facing operating model that reduces confusion, improves response time, and strengthens accountability.
- Partner with centralized Lab/DI, Referral, DME, RPM, Scheduling, Clinical, Revenue Cycle, Product, Analytics, and Compliance teams.
- Escalate systemic barriers affecting pod performance, patient care, billing readiness, or provider experience.
- Support workflow redesign across departments to improve turnaround time and reduce duplication.
- Ensure operational handoffs are clear between provider pods, supervisors, Integrated Care Coordinators, and centralized teams.
- Identify recurring cross-functional breakdowns and recommend process, staffing, or technology solutions.
- Work with hiring, onboarding, training, and development of supervisors and Integrated Care Coordinators.
- Create scalable team structures that allow the integrated care model to expand without losing quality, compliance, or provider trust.
- Identify automation opportunities that reduce manual work, improve productivity, and increase billing capture.
- Use operational dashboards to monitor pod performance, supervisor effectiveness, staff productivity, enrollment trends, billing readiness, and quality outcomes.
- Prepare clear performance summaries for senior leadership.
- Identify trends, risks, and opportunities using data-driven analysis.
- Provide recommendations to improve margin, scale, compliance, and operational execution.
Qualifications
- Bachelor's degree in healthcare administration, Business Administration, Public Health, Nursing, Operations Management, or related field required.
- Master's degree in healthcare administration, Business Administration, Public Health, or a related field preferred.
- Minimum 5-7 years of experience in healthcare operations, population health, care management, remote patient monitoring, value-based care, or clinical operations.
- Minimum of 2-3 years of supervisory or management experience required.
- Experience managing supervisors, team leads, or multi-team operational structures strongly preferred.
- Experience with care management programs such as CCM, APCM, PIN, CHI, BHI, and RPM are strongly preferred.
- Experience in provider-facing operations, panel management, home-based care, or multi-site healthcare operations preferred.
- Proficiency in EMR systems (eClinicalWorks preferred).
- Experience using productivity dashboards and performance tracking tools.
- Strong working knowledge of CCM, PIN, CHI, BHI, and RPM program requirements.
Skills
- Operational leadership and accountability.
- Multi-team performance management.
- Supervisor coaching and staff development.
- Data-driven decision-making.
- Provider relationship management.
- Population health and care management operations.
- Billing readiness and compliance oversight.
- Workflow redesign and process improvement.
- Cross-functional execution.
- Escalation management and problem-solving.
- Scalable workforce planning.
- Executive communication.
Benefits
Essen Health care is proud to be an equal opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.