Senior Director of Integrated Care Services

Adobe Care And Wellness LLC•Phoenix, AZ

11d•Remote

About The Position

The Senior Director of Integrated Care Services is a strategic leader responsible for overseeing Adobe Population Health’s core clinical and population health programs—including Case Management, Health Risk Assessments (HRA), Medicaid Programs, and Adobe Provider Group (APG) operations. This RN-licensed position provides oversight to a multidisciplinary leadership team and ensures that clinical operations align with organizational goals, health plan expectations, and industry best practices. The Senior Director plays a pivotal role in using data-driven strategies to improve clinical outcomes, reduce inpatient (IP) and emergency department (ED) utilization, decrease hospital readmission rates, and drive improvements in the Health Benefit Ratio (HBR). The role ensures all departments meet National Committee for Quality Assurance (NCQA) and Utilization Review Accreditation Commission (URAC) standards, while fostering an integrated and accountable system of care. This position is primarily remote and reports to the VP of Integrated Care Services.

Requirements

Minimum of 8 years of progressive leadership experience in clinical operations, population health, or care coordination.
Demonstrated success improving clinical outcomes and health plan performance metrics, including HBR.
Deep knowledge of Medicaid, Medicare Advantage, and value-based care models.
Strong familiarity with NCQA, URAC, and CMS regulatory frameworks.
Exceptional communication, data interpretation, and leadership skills.
Proficiency in EMR platforms (Salesforce preferred) and Microsoft Office Suite.
Ability and willingness to travel in- and out-of-state as needed.
Bachelor’s degree in nursing, public health, healthcare administration, or related field required.
Active, unrestricted Registered Nurse (RN) license required in all contracted states.

Nice To Haves

Master’s degree preferred.

Responsibilities

Provide direct oversight to Directors and Program Leaders across multiple ICS programs (Medicare Programs, Medicaid Programs, HRA, Transitions of Care, APG California).
Lead multidisciplinary teams with a focus on equity, excellence, and whole-person care.
Drive performance culture by setting clear expectations, mentoring leaders, and fostering accountability.
Oversee hiring, onboarding, training, and performance management for ICS leadership staff. Strategy & Program Management
Develop and implement integrated strategies that enhance quality of care, operational efficiency, and regulatory compliance.
Collaborate with internal leaders and external partners to ensure ICS programs align with health plan contracts and Adobe’s mission.
Coordinate cross-departmental initiatives aimed at streamlining care coordination, transitions of care, and social determinant interventions.
Monitor and analyze program data to identify trends that impact patient outcomes and financial performance.
Use analytics to develop and implement interventions that lower IP and ED utilization, reduce avoidable readmissions, and improve HBR.
Lead the development of performance dashboards and reporting tools to track KPIs, SLAs, and program metrics across ICS programs.
Ensure ongoing readiness and adherence to NCQA and URAC accreditation standards across all ICS programs.
Maintain HIPAA compliance and data security across all clinical workflows.
Lead quality assurance initiatives and support external audits and regulatory reviews.
Serve as a senior liaison with health plans, provider groups, state Medicaid agencies, and community partners.
Represent Adobe at strategic partner meetings, health plan case rounds, and industry events.
Build strong working relationships with internal departments to foster a unified approach to care delivery
Collaborate with the VP of Integrated Care Services to develop and manage departmental budgets.
Monitor and ensure performance against contractual deliverables and financial benchmarks, including HBR improvement targets.
Promote cost-effective service models that maintain high-quality care delivery.
Serve on internal strategic committees and advisory groups as assigned.
Perform additional responsibilities and projects as directed by senior leadership.