Director, Care Management

Vytalize Health

11d

About The Position

The Director of Care Management provides administrative oversight and support to Clinical Services Leadership and contributes to the development, organization, and coordination of the Care Management unit. Reporting to the Vice President of Clinical Services, the role focuses on strategic clinical operations, improving operating and staffing models, efficient resource utilization, and coordination with other departments. The Director advances operational excellence through data analysis, process improvement, performance management, and adherence to regulatory standards. The role also serves as a subject matter expert on Care Management systems and technical programs, acts as a liaison to related vendors and teams, and supports automation within Clinical Services. It develops operational training programs and Care Management system requirements as needed, builds relationships with external partners, and communicates clinical operations performance and progress to senior management.

Requirements

RN, NP, or PharmD license.
In-depth knowledge of healthcare regulations, standards, and best practices related to clinical operations.
Strong leadership and management skills.
Effective communication and interpersonal skills.
Proven track record of driving operational excellence.
Proficiency in healthcare information systems and technology.
Excellent organizational skills and attention to detail.
Entrepreneurial spirit and ability to operate in ambiguity.
Solution-oriented approach with strategic and creative thinking.
Strong work ethic and ability to exceed expectations and goals.
Ability to be coachable and forward-thinking.
Ability to act with integrity, professionalism, and confidentiality.
Proficiency with Microsoft Office Suite or related software.

Nice To Haves

Master’s degree in Business Administration, Public Health, or Health Administration/Management.

Responsibilities

Support the development and implementation of the Care Management clinical operations strategy.
Provide clinical operations subject matter expertise to leadership and Care Management teams.
Support the development and enhancement of operating and staffing models to improve resource utilization and achieve organizational goals.
Use data analysis, report generation, metrics monitoring, and ongoing process improvement to support efficient team operations.
Develop and monitor KPIs to evaluate clinical team operations, identify areas for improvement, and execute improvements.
Streamline processes and workflows based on evidence-based best practices to improve operational efficiency, satisfaction, and productivity.
Collaborate with other departments to coordinate and integrate clinical operations in collaborative initiatives.
Ensure clinical operations comply with relevant regulations, standards, and guidelines.
Implement quality improvement initiatives in collaboration with Corporate Compliance and the Quality Improvement Team.
Develop and implement operational training programs for Care Management staff.
Build relationships with provider partners, external stakeholders, vendors, and community organizations.
Serve as the primary liaison to vendors and teams related to Health Care Management Systems and drive automation within Clinical Services.
Act as a subject matter expert on systems and technical programs used in Care Management.
Write Care Management program and system requirements for Health Care Management tools as necessary.
Communicate regularly with senior management about clinical operations performance and progress.