Director, Customer Care
About The Position
At Umpqua Health, we’re more than a healthcare organization—we’re a community-driven Coordinated Care Organization (CCO) dedicated to improving the health and well-being of individuals and families throughout Douglas County, Oregon. We provide integrated, whole-person care through primary care, specialty care, behavioral health services, and care coordination. Our collaborative approach ensures members receive high-quality, personalized care while supporting a stronger, healthier community. The Director of Care Coordination provides strategic and operational leadership for an evidence-based care coordination program aligned with the Triple Aim: improving member experience, enhancing clinical outcomes, and reducing healthcare costs. This role oversees the Care Coordination department within Umpqua Health Alliance, including team leads, medical and behavioral health case managers, and community health worker (CHW) care navigators. The Director is responsible for ensuring effective team performance, program execution, and alignment with organizational goals. Key responsibilities include developing and advancing care coordination strategies, strengthening provider partnerships, and ensuring seamless delivery of member services. The Director ensures all activities comply with applicable state and federal regulations, as well as organizational policies and standards. This position emphasizes leadership development, team engagement, and the use of data-driven insights to support population health and quality improvement initiatives. The Director also ensures effective resource management, financial stewardship, and safeguarding of protected health information.
Requirements
- Bachelor’s degree in nursing, Social Work, Behavioral Health, Health Administration, or related field.
- Active and unrestricted RN, LCSW, or another applicable clinical licensure in the state of Oregon.
- Minimum of five (5) years of clinical experience.
- Prior management or supervisory experience required.
- Valid driver’s license and ability to maintain appropriate auto insurance, as required.
- Certified Case Manager (CCM) certification, or equivalent, or ability to obtain within two (2) years of hire
- Strong knowledge of medical and behavioral health diagnoses, treatment modalities, and coding systems (ICD-10, DSM-5, CPT).
- Working knowledge of health insurance, managed care models, and Oregon state-mandated benefits.
- Understanding community resources, providers, and support services for members.
- Proficiency in Microsoft Office Suite and general computer systems.
- Not excluded, suspended, or debarred from participation in federal healthcare programs (e.g., Medicare/Medicaid).
Nice To Haves
- Five (5) years of direct health plan experience in case management, utilization management, or disease management.
- Experience developing, analyzing, and interpreting utilization and care coordination reports.
- Experience in adult education, training, or facilitation.
- Experience working in diverse, multidisciplinary teams and adapting to varied communication styles.
- Experience incorporating health equity considerations into program analysis and decision-making.
- Bilingual skills or translation capabilities.
- Experience working within Medicaid Coordinated Care Organizations or similar health plan environments.
Responsibilities
- Develop and implement the strategic direction for the Care Coordination department, ensuring alignment with the Triple Aim, Population Health strategy, and organizational goals of Umpqua Health Alliance.
- Lead and oversee Care Coordination operations, including clinical and non-clinical teams such as care coordinators, case managers, behavioral health staff, and community health worker navigators.
- Provide leadership, coaching, and development to team leads and staff, fostering a collaborative, high-performing team culture.
- Ensure integration of Care Coordination with Population Health, Quality Improvement, Utilization Management, and other internal departments to support coordinated member care.
- Establish and monitor performance metrics, reporting tools, and quality improvement initiatives to evaluate program effectiveness and identify opportunities for improvement.
- Oversee care coordination activities across Behavioral Health, Long Term Services and Supports (LTSS), Transitional Care, and Medical Care Coordination programs.
- Collaborate with providers, community partners, and internal stakeholders to enhance member experience and ensure continuity of care.
- Ensure compliance with all applicable federal and state regulations, including CMS, Oregon Health Authority (OHA) requirements, HIPAA, and internal policies.
- Partner with leadership to develop and manage departmental budgets, monitor expenditures, and support financial stewardship.
- Analyze program and operational data to guide decision-making, support innovation, and improve outcomes through LEAN and continuous improvement methodologies.
- Oversee use of care coordination systems and tools to support workflow efficiency, productivity tracking, and reporting.
- Participate in cross-functional committees and initiatives to support organizational alignment and strategic priorities.
- Ensure confidentiality, data security, and appropriate handling of protected health information at all times
Benefits
- Salary is dependent on skills, experience, and education
- Generous benefits package including vacation PTO, sick leave, federal holidays, and birthday leave
- Medical, dental, and vision insurance
- 401(k) with company match (fully vested immediately)
- Company-sponsored life insurance and additional benefits
- Fitness reimbursement program
- Tuition reimbursement and more
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What This Job Offers
Job Type
Full-time
Career Level
Director
