REMOTE - Regional Director, Care Management Market Liaison - R8799

CareSource; United States; Remote; USD 132,000 - 233,000; Full time

Job summary

A leading healthcare provider seeks a Regional Director for Care Management Market Liaison to oversee operational policies, collaborate with leadership, and ensure compliance with regulatory standards. This role involves developing strategies for new business readiness and managing care management processes across multiple markets.

Benefits

Comprehensive benefits

Additional bonuses

Qualifications

• At least five years of healthcare experience in care management.
• At least five years of management experience.

Responsibilities

• Oversee operational policies and procedures related to care management.
• Develop portfolio strategies for new and existing markets.
• Lead operational teams to support market needs and process improvements.

Skills

Leadership

Problem Solving

Communication

Analytic Skills

Education

Bachelor’s Degree in Finance, Business, Healthcare

Tools

Microsoft Office Suite

Job description

REMOTE - Regional Director, Care Management Market Liaison - R8799

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Job Summary

The Regional Director, Care Management Market Liaison works directly with leadership in assigned markets to execute, standardize, and support the Care Management approach in collaboration with care management leadership. This role supports new business readiness and implementation activities, including developing Model of Care documents for Medicare lines of business.

Essential Functions

• Work with Care Management leadership to oversee operational policies, procedures, and clinical content related to the standardized model, regulatory, and accreditation standards.
• Develop portfolio strategies to align across programs, coordinate deliverables, and optimize resources for new and existing markets.
• Ensure strategies are in place for risk identification, mitigation, and contingency planning.
• Lead process development to achieve operational excellence within the care model for all supported markets.
• Collaborate with care management leadership to maintain documentation related to workflows and processes.
• Manage process changes resulting from regulatory/compliance requirements to ensure alignment with the model and minimize variance.
• Assist in setting benchmarks, goals, and outcomes for Care Management programs and related specialty programs.
• Oversee the care management policy process, including evaluation, development, and execution.
• Lead operational teams to support market needs, business implementation, and process improvements.
• Participate in new business activities, including RFPs, readiness, and implementation.
• Support development and updates of Model of Care documents for Medicare.
• Perform other related duties as assigned.

Education and Experience

• Bachelor’s Degree in Finance, Business, Healthcare, or equivalent experience.
• At least five (5) years of healthcare experience in care management.
• At least five (5) years of clinical improvement or process redesign experience.
• At least five (5) years of management experience.

Competencies, Knowledge, and Skills

• Proficiency in Microsoft Office Suite.
• Strong listening, thinking, planning, and problem-solving skills.
• Ability to maintain confidentiality and act in the company's best interest.
• Excellent communication and leadership skills.
• Ability to manage multiple markets and teams.
• Knowledge of regulatory reporting and compliance.
• Experience with quality and performance improvement.
• Strong analytic skills and clinical expertise in disease management and clinical processes.
• Experience in high-growth environments.
• Knowledge of clinical policies and procedures.

Licensure and Certification

• Current, unrestricted RN or LCSW licensure preferred.
• Case Management Certification (CCM) preferred.
• Influenza vaccination required during flu season.

Working Conditions

• Office environment, with potential for extended sitting or standing.

Compensation Range

$132,900.00 - $232,700.00, based on education, experience, and role scope. Additional bonuses may apply. CareSource offers comprehensive benefits.

Employment Details

• Full-time
• Director level

Job Function and Industry

• Health Care Provider
• Insurance

CareSource is an Equal Opportunity Employer committed to diversity and inclusion.