Senior Director, Chronic Care Management (CCM) Operations

Medrina•Chicago, FL

6d•$170,000•Remote

About The Position

Medrina has been voted one of the fastest growing companies and 92% of our employees feel we are a Great Place to Work! This is a full-time role operating remotely during standard business hours with as-needed travel requirement. This is not a flexible schedule opportunity. We offer an annual salary of $170,000 and a robust benefits package including 15 days of vacation, 7 paid holidays, and 5 sick days annually. Group benefits, which begin day one, include numerous health/dental/vision plans, employer-paid life insurance, 401(k) with a company match and more. The Senior Director of CCM Operations is responsible for the strategic development, operational execution, and performance optimization of the organization’s Chronic Care Management (CCM) program across all markets. This leader will drive scalable care models that improve patient outcomes, enhance care coordination, and maximize reimbursement within value-based and fee-for-service environments. This role partners closely with clinical leadership, revenue cycle, technology, and field operations to ensure CCM programs are compliant, efficient, and aligned with organizational growth objectives. This role reports to COO.

Requirements

Bachelor’s degree required; Master’s degree (MBA, MHA, MPH, or clinical degree) preferred
8–12+ years of healthcare operations experience, with significant focus on CCM, population health, or care management
Experience in multi-site medical groups, post-acute care, or value-based care environments strongly preferred
Proven success scaling clinical programs across multiple markets
Deep understanding of CMS CCM, TCM, and related programs
Strong financial acumen with experience managing P&L
Expertise in care coordination workflows and staffing models
Experience with EHRs, care management platforms, and data analytics tools
Strong leadership, communication, and change management skills

Nice To Haves

Experience in SNF or post-acute care models
Familiarity with Medicare Advantage and ACO structures
Experience building centralized care management programs
Background in integrating CCM with telehealth or virtual care

Responsibilities

Strategic Leadership Design and execute a comprehensive CCM strategy across ambulatory, post-acute, and SNF settings
Identify growth opportunities including new markets, service lines (e.g., RPM, TCM integration), and payer partnerships
Develop scalable care models to support multi-state expansion
Align CCM initiatives with value-based care objectives, including ACO, Medicare Advantage, and bundled payment programs
Operational Oversight Lead day-to-day CCM operations across multiple regions and care settings
Standardize workflows for patient identification, enrollment, consent, care planning, and monthly engagement
Implement centralized and/or hybrid care coordination models (e.g., call centers, virtual teams)
Optimize staffing models including RNs, LPNs, MAs, and care coordinators
Establish SLAs and performance benchmarks across markets
Clinical & Program Quality Ensure CCM services meet CMS guidelines and documentation requirements
Partner with clinical leadership to develop evidence-based care plans and protocols
Monitor quality metrics including: Hospital readmissions ED utilization Patient engagement rates Care gap closure
Drive continuous quality improvement initiatives
Financial Performance & Revenue Cycle Own CCM P&L, including revenue growth, cost management, and margin optimization
Partner with billing and coding teams to ensure accurate capture of CCM services (e.g., CPT 99490, 99439, 99487, 99489)
Monitor key financial KPIs: Enrollment rates Minutes per patient per month Reimbursement per patient Denial rates
Identify and implement revenue optimization strategies
Technology & Data Analytics Oversee implementation and optimization of CCM platforms, EHR integrations, and telehealth tools
Utilize data analytics to track performance, identify trends, and drive decision-making
Implement dashboards for real-time visibility into operational and financial metrics
Ensure interoperability between hospital, SNF, and community-based systems
Cross-Functional Collaboration Partner with: Clinical leadership (CMO, Medical Directors) Field operations and regional leaders Revenue cycle management IT and digital health teams Business development and payer contracting Support integration of CCM with TCM, RPM, and other population health programs
Team Leadership & Development Build and lead a high-performing CCM operations team
Develop leadership structure across regions (e.g., regional directors, managers)
Establish training programs for care coordinators and clinical staff
Foster a culture of accountability, collaboration, and patient-centered care