Senior Clinical Care Management Leader

EmblemHealth, Inc.; United States; On-site; USD 120,000 - 180,000; Full time

Job summary

EmblemHealth, Inc. seeks a senior leader to provide clinical oversight of Care Management and Community Health Worker teams serving members with complex medical, behavioral health, and social needs.

The role directs daily operations, caseload distribution, documentation timeliness, and high-risk population management, ensuring evidence-based, member-centered care. The incumbent will drive performance using quality, outcome, productivity data; ensure NCQA/CMS compliance; collaborate across

Qualifications

• Bachelor's degree required, preferably in Nursing.
• Current New York State RN license required.
• CCM certification preferred.
• 5-8+ years of clinical experience (Required).
• Experience leading care management teams (Required).

Responsibilities

• Provide clinical leadership and oversight of care management operations.
• Direct daily care management operations including caseload distribution and workflow optimization.
• Ensure timely documentation and regulatory/compliance standards are met.
• Collaborate with cross-functional teams to improve quality and cost-of-care outcomes.

Skills

Leadership

Analytical skills

Communication

Prioritization

MS Office

Education

Bachelor's degree

CCM certification

RN license (NY)

Tools

MS Office

Job description

EmblemHealth, Inc. seeks a senior leader to provide clinical oversight of Care Management and Community Health Worker teams serving members with complex medical, behavioral health, and social needs.

The role directs daily operations, caseload distribution, documentation timeliness, and high-risk population management, ensuring evidence-based, member-centered care. The incumbent will drive performance using quality, outcome, productivity data; ensure NCQA/CMS compliance; collaborate across