Mgr-Care Management Performance Optimization (Full-time Remote, North Carolina Based)

Alliance Health in; Morrisville (NC); Remote; USD 91,000 - 116,000; Full time

Benefits offered by this job

Hybrid/Remote options

Generous retirement savings plan

Paid time off

Job summary

Alliance Health is seeking a Manager - Care Management Performance Optimization to drive operational alignment across the Care Management department. The role focuses on identifying performance gaps, streamlining processes, and leading cross-functional projects to improve quality, cost-efficiency, and member satisfaction.

This full-time remote position requires residence in North Carolina with occasional travel to the Morrisville home office for onsite meetings as needed.

Qualifications

• Bachelor's degree in Nursing, Healthcare Administration, or related field and 5+ years in health care operations.
• Master's degree in related field and 3+ years in care management or population health.
• Lean Six Sigma Green Belt required within 1 year of hire.

Responsibilities

• Monitor, analyze, and report care management KPIs.
• Develop performance dashboards and reporting tools.
• Identify gaps and lead root-cause analysis and action planning.
• Improve care management workflows and documentation.
• Support projects to streamline operations and improve outcomes.
• Ensure compliance with regulatory and contractual requirements.

Skills

Data analysis

Communication skills

Project management

Change leadership

Healthcare regulations

Education

Bachelor's degree in Healthcare Administration or Nursing

Master's degree in Healthcare Admin or related field

Tools

Microsoft Office

Data analytics tools

Job description

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Mgr-Care Management Performance Optimization (Full-time Remote, North Carolina Based)

Locations

Showing 1 location

Home Office
Morrisville, NC 27560, USA

• Remote
• Care Management
• Full-Time
• Requisition #: MGRCA003630

Description

The Manager - Care Management Performance Optimization is responsible for driving operational alignment and leading performance and optimization initiatives across the Care Management department. The role focuses on identifying performance gaps, streamlining processes, enhancing service delivery, and executing cross-functional projects to improve quality, cost-efficiency, and member satisfaction.

This position is full-time remote. Selected candidate must reside in North Carolina and be willing to travel to the home office (Morrisville, NC) for onsite team meetings as needed

Responsibilities & Duties

Performance Management

• Monitor, analyze, and report on care management KPIs
• Collaborate with care management leadership and others to develop performance dashboards and reporting tools
• Identify performance gaps and lead root cause analysis and action planning
• Improve care management business processes by enhancing operational efficiencies
• Develop and maintain standardized care management workflows and documentation practices

Optimization

• Support CM leadership with projects targeted to address care management high priority operations
• Implement Lean Six Sigma, or similar process improvement models/methodologies to reduce costs, improve quality and enhance member experience
• Manage initiatives/workstreams that streamline workflows, reduce administrative burden and improve member outcomes
• Support change management initiatives and CM specific operational projects to ensure effective adoption of new processes or technologies

Operational Excellence and Compliance

• Act as the liaison within Care Management department and between cross-functional areas to drive process improvement initiatives aligned with the organization’s business goals and targets
• Lead and/or participate in interdisciplinary committee or workgroups as determined by leadership
• Ensure high standards of care and support services are delivered in compliance with regulatory, contractual and legal requirements and obligations
• Contribute to long-term care management strategy through data insights and performance trends

Stakeholder Collaboration and Communication

• Facilitate collaboration between internal and external stakeholders to identify strategic partnerships for the success of program initiatives and requirements
• Generate and present reports, dashboards and ad-hoc analyses to communicate performance, findings and recommendations to leadership and other stakeholders
• Serve as a subject matter expert on care management operations and best practices
• Collaborate with leadership to align operational goals with overall strategic objectives
• Other duties as assigned

Manage and Develop Staff

• Work with Human Resources to attract, maintain, and retain a highly qualified and well-trained workforce
• Ensure staff are well trained in and comply with all organization, department, and oversight agency policies, procedures, and business processes
• Organize workflows and ensure staff understand their roles and responsibilities
• Ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements
• Actively establish and promote a positive, diverse, and inclusive working environment that builds trust
• Ensure all staff are treated with respect and dignity
• Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members
• Work to resolve conflicts and disputes, ensuring that all participants are given a voice
• Set goals for performance and deadlines in line with organization goals and vision
• Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional development
• Cultivate and encourage efforts to expand cross-team collaboration and partnership

Education & Experience

Required :

Bachelor’s degree in Nursing, Healthcare Administration, Human Services, Public Health, Business Administration, Data Analytics, or related field from an accredited college/university and five (5) years of experience in health care operations, care management or population health of which at least three (3) years of experience in performance improvement, transformation or project management

Or

Master’s degree in Nursing, Healthcare Administration, Human Services, Public Health, Business Administration, Data Analytics, or related field from an accredited college/university and three (3) years of experience in health care operations, care management or population health of which at least two (2) years of experience in performance improvement, transformation or project management.

Lean Six Sigma Green Belt (LSSGB) required within one (1) year of hire.

Preferred :

Knowledge, Skills, & Abilities

• Experience with clinical systems and care management platforms
• Strong analytical and data interpretation skills
• Strong verbal and written communication skills
• Strong organizational and project management, and change leadership skills
• Ability to analyze facts, evaluate policies and devise solutions to problems related to program effectiveness
• Knowledge of healthcare regulations, valued-based care, and care management models
• Use of Microsoft Office products and knowledge of data analytics programs and reporting

Salary Range

$91,192-$116,270/Annually

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.

An excellent fringe benefit package accompanies the salary, which includes:

• Generous retirement savings plan
• Flexible work schedules including hybrid/remote options
• Paid time off including vacation, sick leave, holiday, management leave
• Dress flexibility

Education

Required

Bachelors or better in Healthcare Administration.

Bachelors or better in Human Services.

Bachelors or better in Nursing.

Licenses & Certifications

Required

Preferred

NACCM Certified Care Mgr

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.