AVP, Care Management & Coordination — Strategic Leader

St. Mary's Medical Center Inc; Huntington (WV); On-site; USD 180,000 - 240,000; Full time

Job summary

Marshall Health Network, Inc. seeks an experienced AVP of Care Management to lead enterprise care management, utilization management, and transitions of care across inpatient and ambulatory settings.

You will shape strategy, oversee multidisciplinary teams, and align with Revenue Cycle and Quality teams to improve outcomes and reduce denials. The role emphasizes strategic planning, financial stewardship, data-driven decision making, and collaboration with executive leadership to drive

Qualifications

• Master's degree in Nursing, Healthcare Administration, Business Administration, Public Health, Social Work, or a related field.
• At least 10 years of progressive healthcare leadership and clinical experience.
• At least five years of senior leadership experience overseeing care management services at one or more facilities or across a health system.
• Demonstrated experience leading large, multidisciplinary teams.
• Experience with value-based care, population health, and healthcare transformation initiatives.
• Extensive knowledge of care management, utilization management, case management, and population health.
• Strong understanding of CMS regulations, managed care, value-based reimbursement, medical necessity criteria, and payer requirements.
• Demonstrated strategic planning, change leadership, financial management, communication, and relationship-building skills.
• Ability to use data and performance measures to guide decisions and achieve measurable results.
• Proficiency with Microsoft Office applications, particularly Excel.

Responsibilities

• Develop and implement the health system's strategic vision for care management across inpatient, outpatient, ambulatory, post-acute, and community settings.
• Oversee care management programs including case management, social work, utilization management, and care coordination.
• Standardize workflows and best practices across hospitals and ambulatory settings.
• Establish staffing models and promote efficient patient throughput, discharge planning, and transitions of care.
• Lead enterprise-wide care management transformation and performance improvement initiatives.
• Partner with Revenue Cycle leadership to strengthen medical necessity compliance, improve utilization management, and reduce denials.
• Establish performance metrics and dashboards to evaluate care management effectiveness.
• Manage departmental operating and capital budgets.
• Identify opportunities to improve financial performance through resource utilization.
• Support Revenue Cycle and patient safety initiatives; optimize value-based payment arrangements.

Skills

Strategic leadership

Healthcare administration

Data-driven decision making

Regulatory knowledge

Excel proficiency

Communication skills

Financial management

Change leadership

Education

Master's degree in Nursing, Healthcare Administration, Business Administration, Public Health, Social Work, or related field

Tools

Power BI

SQL

Epic/Cerner

Excel

Job description

Marshall Health Network, Inc. seeks an experienced AVP of Care Management to lead enterprise care management, utilization management, and transitions of care across inpatient and ambulatory settings.

You will shape strategy, oversee multidisciplinary teams, and align with Revenue Cycle and Quality teams to improve outcomes and reduce denials. The role emphasizes strategic planning, financial stewardship, data-driven decision making, and collaboration with executive leadership to drive