What are the responsibilities and job description for the Senior Director, Care Management position at The Jacobson Group?
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Job Description
Care Management Operations Leader
The Jacobson Group is seeking an experienced Care Management Operations Leader for a contract opportunity with a managed care organization. This leader will oversee a department of approximately 40–50 employees, drive operational improvements, optimize HealthEdge utilization, and maintain regulatory compliance while supporting the team through organizational change.
Responsibilities
- Lead and support a department of 40–50 employees through organizational change, establishing priorities, maintaining accountability, and ensuring operational continuity.
- Assess and optimize the HealthEdge platform to improve care management workflows, data utilization, staff productivity, and operational efficiency.
- Oversee daily care management operations, coordinating member care across medical, behavioral health, provider, and subcontractor networks.
- Ensure compliance with CMS, Medicaid, NCQA, state Department of Insurance, and contractual requirements across applicable lines of business.
- Collaborate with medical leadership, compliance, quality, technology, data analytics, and other stakeholders to resolve challenges and advance departmental goals.
- Monitor operational performance, quality metrics, and productivity indicators; analyze data and communicate findings and recommendations to senior leadership.
- Support employee development, training, and performance while providing guidance to managers and staff on clinical, operational, and workforce challenges.
- Oversee delegated vendors and programs to ensure compliance with contractual obligations, quality standards, and performance expectations.
Requirements
- Bachelor’s degree required.
- Seven or more years of administrative experience within a managed care organization or health plan, including leadership experience.
- Three or more years of supervisory or management experience.
- Experience leading multidisciplinary clinical and non-clinical teams through organizational change.
- Strong knowledge of care management principles, case management strategies, and healthcare operations preferred.
- Familiarity with CMS, Medicaid, NCQA, state regulatory, and health plan accreditation requirements preferred.
- Demonstrated ability to manage people and processes, solve complex operational challenges, and build relationships with internal and external stakeholders.
- Proficiency in Microsoft Excel, including statistical formulas, pivot charts, and data visualization.
- Ability to work Mountain Standard Time (MST) business hours.
- Ability to work a hybrid schedule with onsite travel for up to one week per month, with some flexibility.
Key Skills
- Care Management Operations
- Managed Care and Health Plan Administration
- Team Leadership and Change Management
- HealthEdge Platform Optimization
- Regulatory Compliance and Audit Readiness
- Staff Development and Performance Management
- Vendor and Program Oversight
- Data Analysis and Microsoft Excel
Pay Range
- $85/hour W-2
- Contract duration: 2 months
- Hybrid schedule with onsite work required, up to one week per month
Benefits
Our comprehensive benefits package includes:
- Medical insurance
- Dental insurance
- Vision insurance
- 401(k) retirement savings plan
Contact
Karrie Ruch
The Jacobson Group
kruch@jacobsongroup.com
Refer a Colleague
Know someone who may be a great fit? Contact Karrie Ruch or submit a referral through our referral form.
Salary : $85