Care Management District Leader: CMS Programs

Jobtailor; Missouri; On-site; USD 95,000 - 130,000; Full time

Job summary

Jobtailor is seeking a senior leader to guide care management operations in a healthcare system. The role focuses on executing the strategic vision, implementing CMS care management programs, and driving operational excellence across ambulatory settings.

The successful candidate will build strong stakeholder relationships, ensure policy adherence, and manage workflows to optimize financial and quality outcomes. Previous experience with CMS methodologies is essential for success.

Qualifications

• 5+ years of progressive healthcare operations leadership experience.
• Experience implementing and managing CMS care management programs.
• Experience in ambulatory care, value-based care, population health, or primary care operations.
• Strong knowledge of CMS reimbursement methodologies, quality reporting, and regulatory requirements.

Responsibilities

• Execute the strategic vision established by the Director of Care Management.
• Lead implementation and adoption of new care management programs, workflows, and operational initiatives.
• Coordinate implementation activities with clinic leadership and operational teams.
• Monitor implementation progress and resolve operational barriers.
• Ensure consistent execution of approved workflows, SOPs, and organizational policies.
• Conduct routine operational reviews to evaluate productivity, workflow compliance, patient engagement, and program performance.
• Build strong relationships with providers, Medical Directors, Business Administrators, Care Management Supervisors, and clinic leaders.
• Drive achievement of operational, productivity, enrollment, reimbursement, and financial goals.
• Support Quality Assurance (QA) and Quality Control (QC) initiatives.

Skills

Healthcare Operations Leadership

CMS Care Management Programs

Ambulatory Care Experience

Regulatory Compliance Knowledge

Quality Assurance Initiatives

Education

Bachelor's degree in Healthcare Administration, Nursing, Business Administration, Public Health, or related field

Job description

Jobtailor is seeking a senior leader to guide care management operations in a healthcare system. The role focuses on executing the strategic vision, implementing CMS care management programs, and driving operational excellence across ambulatory settings.

The successful candidate will build strong stakeholder relationships, ensure policy adherence, and manage workflows to optimize financial and quality outcomes. Previous experience with CMS methodologies is essential for success.