What are the responsibilities and job description for the Director of Integrated Case Management - Medicare position at Everly Talent?
A mission-driven healthcare organization in New York City is seeking a Director of Integrated Case Management for Medicare to lead oversight of its Medicare Advantage and Dual Eligible populations. This is a high-impact leadership opportunity with a hybrid schedule, offering the chance to shape strategy while guiding a dedicated, multidisciplinary team.
The Director of Integrated Case Management for Medicare will be responsible for:
- Providing clinical and operational oversight of Medicare Advantage and D-SNP care management programs
- Leading and developing clinical and non-clinical teams to ensure effective, member-centered care delivery
- Ensuring compliance with CMS, State, and local regulations, including adherence to the Model of Care
- Driving quality improvement initiatives, care transitions strategies, and utilization management collaboration
- Analyzing performance data to implement process enhancements and strengthen outcomes
Requirements:
- Active New York State RN license and current registration
- Bachelor of Science in Nursing required; Master’s degree preferred
- 10 years of healthcare management experience, including leadership in managed care
- 5 years in leadership role, Manager and above
- Strong knowledge of CMS and managed care regulations, with experience overseeing clinical teams
Compensation: $155,000.00 to $170,000.00
Salary : $155,000 - $170,000