What are the responsibilities and job description for the CCM Manager position at Hillside Medical Group?
Chronic Care Management (CCM) Manager
Department: Clinical Operations
Reports To: Director, Population Health
FLSA Status: Exempt
Position Summary
The Chronic Care Management (CCM) Manager is responsible for the strategic leadership, operational oversight, regulatory compliance, quality outcomes, and financial performance of Hillside Medical Group's Chronic Care Management Program. This position ensures the CCM program delivers exceptional patient-centered care while maintaining full compliance with CMS, Medicare, HIPAA, state and federal regulations, and payer requirements. The CCM Manager develops and leads a high-performing care management team focused on improving clinical outcomes, reducing unnecessary emergency department visits and hospitalizations, increasing patient engagement, and supporting providers through proactive chronic disease management.
Essential Duties and Responsibilities
Leadership & Operations
● Direct all daily CCM operations across Hillside Medical Group.
● Recruit, develop, coach, and evaluate CCM staff.
● Establish productivity, quality, and performance metrics.
● Develop workflows, policies, and SOPs supporting CCM operations.
● Collaborate with providers, clinical leadership, quality, billing, compliance, IT, and operations.
● Monitor staffing levels and operational efficiency.
Clinical Program Oversight
● Ensure patients meet CMS eligibility requirements.
● Oversee patient identification, enrollment, and consent.
● Ensure comprehensive electronic care plans are developed, maintained, and updated.
● Monitor care coordination activities including:
○ Medication reconciliation
○ Preventive care
○ Specialist coordination
○ Hospital and ED follow-up
○ Patient education
○ Social determinant referrals
● Promote evidence-based chronic disease management.
Compliance & Regulatory Responsibilities
● Maintain compliance with:
○ CMS Chronic Care Management regulations
○ Medicare billing requirements
○ HIPAA Privacy and Security Rules
○ State regulatory requirements
○ Hillside Compliance Program
● Ensure accurate documentation supporting all CCM billing.
● Monitor time tracking and documentation requirements.
● Coordinate internal audits.
● Correct identified deficiencies.
● Participate in compliance investigations when necessary.
● Maintain audit readiness.
Quality & Performance
Responsible for achieving organizational goals related to:
● Patient enrollment growth
● Patient retention
● Hospital admission reduction
● Emergency department utilization reduction
● Clinical quality measures
● Patient satisfaction
● Provider satisfaction
● Care plan completion
● Documentation accuracy
● Billing compliance
● Revenue cycle optimization
Financial Management
● Monitor CCM financial performance.
● Develop annual operational budgets.
● Maximize compliant reimbursement.
● Monitor productivity and staffing efficiency.
● Identify revenue opportunities while maintaining regulatory compliance.
Human Resources Responsibilities
● Hire, train, mentor, and evaluate CCM employees.
● Conduct annual performance evaluations.
● Address employee performance concerns.
● Ensure staff complete mandatory education.
● Promote employee engagement and accountability.
● Maintain confidentiality of personnel information.
Minimum Qualifications
Education
Bachelor's Degree in Nursing, Healthcare Administration, Public Health, Business
Administration, or related healthcare field required.
Master's Degree preferred.
Experience
● Minimum five (5) years healthcare leadership experience.
● Minimum three (3) years managing Chronic Care Management, Care Coordination, Population Health, Value-Based Care, or Quality programs.
● Experience supervising multidisciplinary teams.
● Experience with Medicare CCM billing and documentation requirements.
● Experience working within an EMR.
Preferred Certifications
● Certified Case Manager (CCM)
● Certified Professional in Healthcare Quality (CPHQ)
● Utilization Management Certification
● Lean Healthcare Certification (preferred)
Knowledge, Skills & Abilities
● Strong healthcare operations leadership
● Medicare and CMS regulatory knowledge
● Population Health management
● Chronic Disease Management
● Care Coordination
● Quality Improvement
● Regulatory Compliance
● Revenue Cycle understanding
● HIPAA compliance
● Performance improvement
● Project management
● Data analytics
● Team leadership
● Excellent written and verbal communication
● Microsoft Office proficiency
● EMR proficiency
Performance Expectations
The CCM Manager is expected to:
● Build a patient-centered CCM program.
● Maintain full regulatory compliance.
● Improve patient outcomes.
● Reduce avoidable hospitalizations.
● Increase CCM enrollment.
● Improve patient engagement.
● Maintain audit-ready documentation.
● Meet financial and quality goals.
● Foster collaboration across departments.
● Demonstrate Hillside's mission, values, professionalism, integrity, accountability,
and service excellence.
Working Conditions
● Office-based position with travel between Hillside locations as needed.
● Standard business hours with occasional evenings or weekends.
● Ability to sit, stand, walk, and use computer equipment for extended periods.
Acknowledgement
This job description is intended to describe the general nature and level of work
performed. Duties may be modified to meet organizational needs. Nothing in this
description creates an employment contract.
Hillside Medical Group is an Equal Opportunity Employer.
Salary : $55,000 - $60,000