Director, Care Management

Jobgether

United States
**
Senior clinical leadership experience
Case management strategy design
Utilization management execution
** The position of Director, Care Management, is a senior clinical leadership role focused on enhancing care management within a health plan environment. The successful candidate will design and implement strategies for case and utilization management, collaborating with various teams to ensure high-quality and cost-effective care for members. **

Job Summary

  • This senior clinical leadership position focuses on transforming care management within a modern health plan environment.
  • The role requires leading the design and execution of case management and utilization management strategies to ensure high-quality, evidence-based care.
  • You will collaborate with cross-functional teams including operations, underwriting, analytics, product, and care delivery to shape clinical and cost strategies.

Matching Summary

Match Score: 75

** The position of Director, Care Management, is a senior clinical leadership role focused on enhancing care management within a health plan environment. The successful candidate will design and implement strategies for case and utilization management, collaborating with various teams to ensure high-quality and cost-effective care for members. **

Skills & Requirements

Must-have

  • Senior clinical leadership experience
  • Case management strategy design
  • Utilization management execution
  • Evidence-based care implementation
  • Cross-functional team collaboration

Nice-to-have

  • Population health insights application
  • Medical necessity translation skills
  • High-impact healthcare improvement focus
  • Modern health plan environment knowledge

Key Requirements

  • Clinical background required
  • Leadership in payer operations
  • Experience with medical necessity policies

Work Rights

Not specified

Tailored Resume

Cover Letter