National Director, Complex Care & Utilization Management

AbsoluteCARE Medical Center & Pharmacy; United States; On-site; USD 180,000 - 240,000; Full time

Job summary

AbsoluteCARE Medical Center & Pharmacy is seeking a Senior Director to lead Complex Care Management (CCM) and Utilization Management (UM). This strategic, nationwide role designs, implements, and optimizes integrated care delivery models to improve outcomes for medically and socially complex populations.

It oversees national CCM and UM programs with compliance and operational excellence. The position requires up to 40% travel across AbsoluteCare locations; RN license is preferred, and CCM/URAC

Qualifications

• Bachelor’s degree in Nursing, Public Health, Health Administration, or related field required; Master’s degree preferred.
• Knowledge of Medicaid/Medicare populations and value-based care models is a plus.
• Willingness to travel across markets to interact with leadership and staff.

Responsibilities

• Direct the CCM and UM program strategy across markets and ensure alignment with value-based care principles.
• Oversee program implementation, reporting, and executive communications for CCM and UM.
• Monitor workflows, staffing, and performance metrics; lead training and policy development.
• Develop and mentor a high-performing interdisciplinary team across care managers, CM nurses, and educators.
• Engage with payers, health systems, regulators, and internal stakeholders to ensure transparency and success.

Skills

Strategic leadership

Healthcare operations

Budget management

Regulatory compliance

Team leadership

Education

Bachelor’s degree in Nursing, Public Health, Health Administration, or related field

Master’s degree preferred

Tools

ZeOmega/Jiva EHR

Job description

AbsoluteCARE Medical Center & Pharmacy is seeking a Senior Director to lead Complex Care Management (CCM) and Utilization Management (UM). This strategic, nationwide role designs, implements, and optimizes integrated care delivery models to improve outcomes for medically and socially complex populations.

It oversees national CCM and UM programs with compliance and operational excellence. The position requires up to 40% travel across AbsoluteCare locations; RN license is preferred, and CCM/URAC