Tailored Care Management Director - Corporate

Kaizen Lab Inc.; Greenville (NC); Hybrid; USD 75,000 - 90,000; Full time

Benefits offered by this job

Health coverage

Dental coverage

Vision coverage

Paid time off

401k

Mileage reimbursement

Licensure/CEU support

Job summary

Pathways to Life, Inc. in North Carolina seeks a Tailored Care Management Director to lead the program statewide for NC Medicaid Tailored Plan members with behavioral health and co-occurring conditions.

You will supervise supervisors, care managers, and partners to ensure quality, compliance, and outcomes. This corporate leadership role requires travel across the service area, deep Tailored Care Management experience, and building scalable processes for success.

Qualifications

• Minimum 5 years in behavioral health, care management, care coordination, or health care administration; at least 3 years supervising/leading.
• Prior Tailored Care Management experience at Supervising Care Manager level or above (non-negotiable).
• Working command of the NC Medicaid TCM Provider Manual and related standards.
• Direct experience with populations served: serious mental illness, SMI, SUD, and co-occurring physical health complexity.
• Willingness and ability to travel regularly across the service area for visits, meetings and training.
• Valid NC driver’s license, reliable transportation, current auto insurance, and ability to pass background screening.

Responsibilities

• Own the entire Tailored Care Management program; no slivers of the work.
• Oversee Supervisors, care managers, and extenders; manage hiring, training, compliance, and coverage.
• Maintain certification standards, contracts, documentation integrity, and audit responses.
• Ensure clinical quality via comprehensive assessments, care plans, and multidisciplinary teams.
• Leverage data and partner networks to drive outreach and improve program performance.

Skills

Supervisory leadership

Travel willingness

NC Medicaid TCM knowledge

Data-driven decisions

Education

Master's degree in Social Work, Counseling, Psychology, Public Health, Healthcare Administration, Nursing, or related field

Bachelor’s in a human services field with leadership experience

Job description

Tailored Care Management Director

Pathways to Life, Inc. — North Carolina (Corporate)

Full Time · Exempt

Location flexible within North Carolina

Regular travel required ·

Hiring immediately

You’ve already done the work. Now come run the program.

If you’ve supervised Tailored Care Management, you know what the Provider Manual doesn't tell you: that the 90-day assessment window is really a relationship window. That a care plan is only as good as the care manager who fought to get it signed. That the difference between a compliant program and a good one is whether someone at the top is paying attention to both.

We’re looking for that person.

Pathways to Life is a certified Tailored Care Management provider serving NC Medicaid Tailored Plan members with behavioral health and substance use disorders, including members managing serious co-occurring physical health conditions. Our members live with the hardest combinations of circumstances the system produces — and they deserve a care management program built by someone who has actually sat in the chair.

This is a corporate leadership role. You do not need to live near any of our sites — you do need to be willing to travel across our service area to visit teams, host meetings, deliver training, and show up where the work is happening.

This role is open now and we are moving quickly.

What you’ll own

You are the person accountable for the whole program — not a slice of it.

• The team. Supervisors, care managers, and extenders. Hiring, training compliance, supervisory ratios, coverage during vacancy, and the culture that decides whether good people stay.

• The compliance floor. Certification standards, Tailored Plan contract terms, documentation integrity, audit response, and corrective action through to closure. When a reviewer asks a hard question, you’re the one with the answer and the file to back it up.

• The clinical quality. Comprehensive assessments, Care Plans, multidisciplinary care teams, case conferences, transitional care, and access to clinical consultants for the cases nobody has seen before.

• The data. Beneficiary assignment files, claims and encounter data, acuity tiering, Patient Risk Lists, and quality measures — turned into decisions about who gets outreach first and where the program is quietly failing.

• The relationships. Tailored Plan and LME/MCO partners, primary care, hospitals, housing, DSS, justice partners, and the community organizations that make a referral real instead of a line in a chart.

What we require

This is not an entry point into Tailored Care Management. We need someone who can walk in and lead on day one.

• Prior Tailored Care Management experience at the Supervising Care Manager level or above. Non-negotiable. You have supervised care managers, reviewed assessments and care plans, and carried real accountability for a TCM panel.

• Minimum 5 years in behavioral health, care management, care coordination, or health care administration, including at least 3 years supervising or leading.

• Master's degree in Social Work, Counseling, Psychology, Public Health, Healthcare Administration, Nursing, or a closely related field. A bachelor’s in a human services field with substantial leadership experience will be considered.

• Working command of the NC Medicaid TCM Provider Manual — supervisory ratios, qualification standards, assessment and care plan timeframes, qualifying contacts, and the six core Health Home services should already be familiar territory.

• Direct experience with the populations we serve: serious mental illness, serious and persistent mental illness, substance use disorder, and co-occurring physical health complexity.

• Willingness and ability to travel regularly across our service area for site visits, team meetings, training, and partner engagements.

• Valid NC driver’s license, reliable transportation, current auto insurance, and ability to pass criminal background and healthcare exclusion screening.

What moves you to the top of the pile

• NC clinical licensure — LCSW, LCMHC, LMFT, LCAS, LPA, Licensed Psychologist, or RN. (Required if you will also serve as a supervising care manager for any assigned member.)

• Experience with Innovations or TBI waiver coordination, 1915(i) services, or Transition to Community Living.

• You’ve been through a certification review, a Tailored Plan audit, or corrective action plan — and came out the other side stronger.

• Comfort working with actual data files, not just dashboards someone built for you.

• Experience building a program from a small footprint into a durable service line.

Why now

We are growing, and our members are already here. Every week this seat sits empty is a week our supervisors carry more than they should and our care managers get less support than they've earned. We would rather wait for the right person than hire the wrong one — but we are interviewing on a rolling basis and we are prepared to move fast for a strong candidate.

If that's you, don't wait for a polished cover letter. Send what you have.

Compensation & benefits

• Salary range: $75,000 – $90,000, commensurate with licensure and TCM leadership experience

• Health, dental, and vision coverage

• Paid time off and holidays

• 401k

• Mileage reimbursement, licensure/CEU support, supervision toward licensure where applicable

Pathways to Life, Inc. is an equal opportunity employer. We are committed to building a workforce that reflects the communities we serve, and we especially encourage applications from candidates with lived experience of the systems our members navigate.