Director of Care Management

LSMA Management, Inc.; San Bernardino (CA); On-site; USD 130,000 - 145,000; Full time

Job summary

LSMA Management, Inc. seeks a Director of Care Management to oversee the development, implementation, and ongoing management of all Care Management programs.

The role ensures regulatory compliance and crafts efficient patient-care processes, guiding the Care Management team to deliver high-quality, patient-centered outcomes. The Director partners with clinical and non-clinical staff, physicians, leadership, patients, and community resources to advance care delivery and performance across

Qualifications

• Bachelor's degree in Nursing, Healthcare Administration, Public Health, Social Work, or a closely related healthcare field.
• Master's degree (MSN, MHA, MPH, MBA, or MSW) or completion of Vocational Nursing or Registered Nursing program.
• Minimum of five years of progressive care management experience with at least three years in a leadership role.
• Experience with NCQA accreditation and managing Medicare Advantage, Medi-Cal, Dual Eligible, or Commercial populations is a plus.

Responsibilities

• Oversee implementation, development, and management of all Care Management programs.
• Ensure compliance with regulatory requirements and establish efficient patient care processes.
• Provide leadership to the Care Management team and collaborate with clinical and non-clinical staff.
• Coordinate with physicians, leadership, patients, and community resources to deliver quality patient-centered care and achieve optimal outcomes.

Skills

Leadership

Communication

Cross-functional collaboration

Problem-solving

Regulatory compliance

Education

Bachelor's degree

Master's degree or RN program

Job description

JOB SUMMARY

The Director of Care Management is responsible for overseeing the implementation, development, and management of all Care Management programs. This role ensures compliance with all regulatory requirements, establishes efficient processes for patient care management in appropriate programs, and provides leadership to the Care Management team. The Director works collaboratively with clinical and non-clinical staff, physicians, all levels of company leadership, patients, and community resources to deliver quality patient-centered care and achieve optimal outcomes.

DESCRIPTION

The Director of Care Management is responsible for overseeing the implementation, development, and management of all Care Management programs. This role ensures compliance with all regulatory requirements, establishes efficient processes for patient care management in appropriate programs, and provides leadership to the Care Management team. The Director works collaboratively with clinical and non-clinical staff, physicians, all levels of company leadership, patients, and community resources to deliver quality patient-centered care and achieve optimal outcomes.

REQUIREMENTS

MINIMUM & PREFERRED QUALIFICATIONS

Education/Training

Minimum: Bachelor's degree in Nursing, Healthcare Administration, Public Health, Social Work, or a closely related healthcare field.

Preferred: Master's degree (MSN, MHA, MPH, MBA, or MSW) or completion of Vocational Nursing or Registered Nursing program.

Experience

Minimum: At least five years of progressive experience in care management, population health, or clinical operations, with at least three years in a leadership or management role.

Preferred: At least ten years of managed care experience. Experience in delegated managed care organizations. Experience with NCQA accreditation. Experience managing Medicare Advantage, Medi-Cal, Dual Eligible, or Commercial populations. Experience developing departmental budgets and strategic initiatives.

Any combination of educational and work experience that would be equivalent to the stated minimum requirements would qualify for consideration of this position.

Certification(s)

Current unrestricted California RN or LVN license preferred.

Certified Case Manager (CCM), ACM, or other nationally recognized Care Management certification preferred.

Skills, Knowledge & Abilities

• Strong leadership, organizational, and communication skills.
• Ability to collaborate with interdisciplinary teams and manage cross-functional relationships.
• Foster a positive work environment that promotes teamwork, professionalism, and continuous improvement to meet the organizational goals and expectations.
• Communicate effectively with leadership, team members, and external contacts.
• Ability to work effectively with others, delegate responsibilities, and independently manage tasks while meeting established deadlines.
• Problem-solving and critical thinking skills.
• In depth knowledge of industry best practices and regulatory compliance.

Physical, Mental & Environmental Requirements

The physical, mental, and environmental demands described here are representative of those required to successfully perform the essential functions of this job. This position requires the ability to remain sitting for extended periods in an office and/or remote environment, along with frequent repetitive motions such as typing, clicking, and handling documents. The role may occasionally require lifting items weighing up to 25 pounds, such as files or office supplies. Successful performance requires sustained attention to detail, strong focus, and the ability to maintain mental concentration over long durations. Work is typically performed in a standard office or clinical administrative environment and may involve regular exposure to confidential health information. Additionally, the position requires the capacity to manage stress associated with deadlines, high-volume workloads, and the fast -paced nature of health information operations.

PAY RANGE

$130,000.00 - $145,000.00 / annually