Sr Dir-Care Management Operations (Full-time Hybrid, Morrisville, North Carolina Based)

The Senior Director of Care Management Operations oversees daily operations of Alliance’s Care Management (CM) efforts to align with policy and procedures, evidenced based practice, contractual, regulatory, and accreditation requirements.

The Senior Director of Care Management Operations, in collaboration with the Care Management SVP and other department leadership, will drive operational strategy to ensure positive member outcomes through care management interventions. It will include accountability for staff satisfaction, performance, productivity, and compliance with operational procedures. This role will strategize on maximization of staff expertise and skills to support an integrated care management model of care. 

This position will participate in strategic planning as a member of the Clinical Operations senior leadership team.

This is a full-time hybrid opportunity. Selected candidate must be available to report onsite to the Alliance Office in Morrisville for business meetings as needed. 

Responsibilities & Duties

Strategic Leadership and Care Management Operations

• Provide senior leadership level oversight and direction for Tailored Care Management, Care Coordination and Care Transitions functions with the Care Management Department including member outreach, engagement and onboarding
  
• Manage and prioritize multiple projects and requirements
  
• Ensure that daily CM operations are in alignment with policy and procedures, evidenced base practices, contractual, regulatory, and accreditation requirements
  
• Identify efficiencies, staff development, and process gaps; proposing and advocating for a resolution to ensure appropriate resources and tools for staff and member success in alignment with requirements for licensure, contractual, regulatory, accreditation, and evidenced base practice
  
• Identify reporting needs and facilitate requirements development for staff productivity and performance monitoring. This includes, but is not limited to, caseloads, member outreach and engagement, alignment with CM contract requirements, KPI metrics, TCM billing, and documentation standards
  
• Review member outcome data trends and analyze the impact of care management efforts to improve outcomes
  
• Collaborate and coordinate with other Clinical Operations leaders to ensure the delivery of effective, efficient, integrated and evidenced based services and interventions
  
• Collaborate with SVP and other leaders within Care Management to identify opportunities for and strategy to operationalize improvements to the  integrated care management model
  
• Remain cognizant of current Alliance and departmental spending trends and the effect on the availability of fiscal resources; support  budget requirements and amendments aligned with with SVP of Care Management and Chief Medical Officer

 Team Leadership and Development

• Work with Human Resources to maintain and retain a highly qualified and well-trained workforce
  
• Set goals for performance and deadlines in line with departmental and organization goals and vision
  
• Lead, mentor and supervise program directors and clinical managers to maintain high standards of care and operational excellence. This may include routine review of progress towards established targets and goals, as well as project alignment with business operations requests and 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
  
• Provide subject matter expertise to the Clinical Education Team  to advise on staff development needs, training content, and facilitate barriers to training development as it relates to process and/or workflows
  
• Cultivate and encourage efforts to expand cross-team collaboration and partnership

Internal and External Stakeholder Collaboration and Communication

• Present and articulate effectively to Alliance leadersh