Job Description
Position Summary The Director, Care Management is a senior operational leader responsible for the day-to-day management, performance, and quality of Care Management programs. Reporting to the Senior Director, Care Management, this role provides direct oversight of Care Management Supervisors and ensures that frontline teams deliver high-quality, person-centered, and compliant services to members with complex medical, behavioral health, and social needs.
The Director translates strategic direction into effective operations, driving program performance, staff development, quality outcomes, and strong payor relationships while maintaining close visibility into frontline service delivery.
Key Responsibilities Program Operations & Performance - Lead day-to-day operations of Care Management programs to achieve strong performance across quality, outcomes, participant satisfaction, payor satisfaction, and financial targets.
- Ensure compliance with DHCS requirements, managed care contracts, and organizational policies and procedures.
- Maintain in-depth knowledge of all program contracts and ensure operational workflows align with contract specifications.
- Monitor program dashboards and performance metrics including caseloads, engagement benchmarks, outcomes, and staffing ratios; proactively identify risks and implement corrective action plans.
- Maintain a strong understanding of frontline operations by remaining hands-on and available to support complex or escalated member cases as needed.
Quality Assurance & Compliance - Oversee the quality, accuracy, and timeliness of documentation, including assessments, care plans, case notes, and reports submitted to payors.
- Partner with Quality Management and Analytics teams to track outcomes, identify trends, and implement continuous quality improvement initiatives.
- Ensure audit readiness and support internal and external audits, chart reviews, and monitoring activities.
- Develop, refine, and implement policies, procedures, and quality standards to support consistent and compliant service delivery.
Leadership & Staff Development - Directly supervise Care Management Supervisors, providing regular coaching, feedback, and performance management.
- Ensure supervisors are effectively supporting Care Managers through structured supervision, case consultation, and professional development.
- Conduct regular one-on-one meetings, team meetings, and performance reviews; address performance issues through coaching and corrective action as needed.
- Partner with Training staff to design, deliver, and refine onboarding and ongoing training for supervisors and frontline staff.
- Promote a positive, trauma-informed, and mission-driven culture that values collaboration, accountability, staff wellness, and retention.
Staffing & Resource Management - Partner with senior leadership and HR to recruit, hire, and onboard supervisors and program staff in alignment with staffing models and growth plans.
- Ensure staffing ratios, coverage, and workload distribution support timely and effective service delivery.
- Monitor productivity and utilization to balance quality care with financial sustainability.
Account Management & Stakeholder Collaboration - Support the Senior Director in day-to-day account management with managed care plans and payors.
- Participate in regular meetings with health plans, providers, and community partners to review performance, resolve operational issues, and support program growth.
- Serve as an internal liaison between supervisors, frontline teams, and cross-functional departments including Quality, Analytics, Training, and Finance.
Growth & Continuous Improvement - Ensure all referrals are addressed within contract-required timelines.
- Support program growth initiatives by identifying operational improvements, referral opportunities, and partnership strategies.
- Contribute to grant development, reporting, and special initiatives as assigned.
- Lead implementation of new initiatives, pilots, or process changes to enhance care delivery and outcomes.
Required Qualifications - Bachelor's degree in Social Work, Public Health, Health Administration, Human Services, or a related field; Master's degree preferred.
- Minimum of three (5) years of progressive leadership or supervisory experience in care management, care coordination, or related healthcare or social service programs.
- Hands-on experience in care management or case management, preferably with high-acuity or underserved populations.
- Demonstrated knowledge of Medi-Cal, managed care environments, and community-based service systems.
Preferred Qualifications - Experience leading ECM, CICM, or similar Medicare/DSNP or Medi-Cal managed care programs.
- Experience managing contracts, performance metrics, and program budgets.
- Bilingual and bicultural skills reflective of the communities served.
Skills & Competencies - Strong operational leadership with the ability to translate strategy into execution.
- Excellent coaching, supervision, and team development skills.
- Ability to analyze data, manage dashboards, and use metrics to drive performance.
- Strong written and verbal communication skills, including the ability to present program performance clearly and succinctly.
- Collaborative leadership style with the ability to build strong relationships across teams and external partners.
- Highly organized, detail-oriented, and able to manage multiple priorities in a fast-paced environment.
- Comfort working independently while maintaining alignment with senior leadership goals.
Hybrid role.
Partners in Care Foundation is an equal opportunity employer. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment which is free of harassment, discrimination, or retaliation because of age, race (including hair texture and protective hairstyles, such as braids, locks, and twists), color, national origin, ancestry, religion, sex, sexual orientation, pregnancy (including childbirth, lactation/breastfeeding, and related medical conditions), physical or mental disability, genetic information (including testing and characteristics, as well as those of family members), veteran status, uniformed service member status, gender, gender identity, gender expression, transgender status, arrest or conviction record, domestic violence victim status, credit history, unemployment status, caregiver status, sexual and reproductive health decisions, salary history or any other status protected by federal, state, or local laws. All qualified applicants will receive consideration for employment and reasonable accommodations may be made to enable qualified individuals to perform the essential functions of the position.
Job Tags
Contract work, Local area,