Director, Enhanced Care Management in United States at Jobgether

This position is posted by Jobgether on behalf of partner. We are currently looking for a Director, Enhanced Care Management in United States.

This leadership role oversees the strategy, execution, and performance of a large-scale Enhanced Care Management program supporting individuals with complex healthcare needs. The Director is responsible for driving operational excellence, regulatory compliance, and high-quality patient outcomes across care management teams. This role plays a critical part in shaping program design, improving care delivery workflows, and ensuring alignment with CalAIM requirements and organizational goals. Acting as both an operational leader and strategic partner, the Director collaborates closely with clinical, business, and external stakeholders. The environment is fast-paced, mission-driven, and focused on improving access to care and quality of life for vulnerable populations. This position also requires strong analytical and leadership capabilities to manage risk, performance metrics, and continuous improvement initiatives.

• Lead and supervise Clinical Managers, Clinical Consultants, Lead Care Managers, and support staff to ensure effective program execution and team performance
• Oversee day-to-day Enhanced Care Management operations, including assessments, care planning, intake processes, crisis intervention, and transition planning
• Ensure compliance with CalAIM requirements, contractual obligations, SLAs, billing standards, and regulatory guidelines
• Develop and implement policies, SOPs, workflows, and quality assurance programs to optimize care delivery and client experience
• Monitor KPIs, program performance metrics, and operational outcomes, ensuring alignment with organizational objectives and health plan expectations
• Manage reporting, EHR data integrity, claims submission processes, denials, and reimbursement tracking
• Collaborate cross-functionally with clinical, business development, and operations teams to improve referrals, onboarding, and care coordination
• Represent the organization in meetings with health plans, vendors, and community stakeholders while supporting strategic growth initiatives

Requirements:

• Bachelor’s degree highly preferred or equivalent experience
• 5+ years of progressive people management experience in healthcare or care delivery environments
• 3+ years of experience in care management, preferably within Enhanced Care Management or CalAIM programs
• Strong understanding of healthcare operations, regulatory frameworks, and managed care systems
• Proven experience managing performance metrics, budgets, and operational outcomes with P&L responsibility preferred
• Excellent leadership, communication, and stakeholder management skills in complex, cross-functional environments
• Ability to work effectively in a remote, fast-paced, and highly collaborative setting
• Strong analytical thinking, problem-solving skills, and ability to manage competing priorities
• Experience working with diverse populations with cultural sensitivity and professionalism

Benefits:

• Competitive salary range of $145,000 to $160,000 annually, based on experience and location
• Comprehensive medical, dental, and vision insurance coverage
• Income protection benefits and 401(k) retirement plan
• Flexible paid time off and company holidays
• Access to wellness programs and employee support resources
• Mileage reimbursement for eligible field-related travel per IRS guidelines
• Remote work flexibility with occasional travel for training and business needs