Department: Enhanced Care Management (ECM) OR California Integrated Care Management (CICM)
Reports To: Program Senior Director
FLSA Classification: Exempt
Pay Range: $82,000-100,000
Position Summary
The Director, Care Management is a senior operational leader responsible for the day-to-day management, performance, and quality of Care Management programs. Reporting to the Senior Director, Care Management, this role provides direct oversight of Care Management Supervisors and ensures that frontline teams deliver high-quality, person-centered, and compliant services to members with complex medical, behavioral health, and social needs.
The Director translates strategic direction into effective operations, driving program performance, staff development, quality outcomes, and strong payor relationships while maintaining close visibility into frontline service delivery.
Key Responsibilities
Program Operations & Performance
- Lead day-to-day operations of Care Management programs to achieve strong performance across quality, outcomes, participant satisfaction, payor satisfaction, and financial targets.
- Ensure compliance with DHCS requirements, managed care contracts, and organizational policies and procedures.
- Maintain in-depth knowledge of all program contracts and ensure operational workflows align with contract specifications.
- Monitor program dashboards and performance metrics including caseloads, engagement benchmarks, outcomes, and staffing ratios; proactively identify risks and implement corrective action plans.
- Maintain a strong understanding of frontline operations by remaining hands-on and available to support complex or escalated member cases as needed.
Quality Assurance & Compliance
- Oversee the quality, accuracy, and timeliness of documentation, including assessments, care plans, case notes, and reports submitted to payors.
- Partner with Quality Management and Analytics teams to track outcomes, identify trends, and implement continuous quality improvement initiatives.
- Ensure audit readiness and support internal and external audits, chart reviews, and monitoring activities.
- Develop, refine, and implement policies, procedures, and quality standards to support consistent and compliant service delivery.
Leadership & Staff Development
- Directly supervise Care Management Supervisors, providing regular coaching, feedback, and performance management.
- Ensure supervisors are effectively supporting Care Managers through structured supervision, case consultation, and professional development.
- Conduct regular one-on-one meetings, team meetings, and performance reviews; address performance issues through coaching and corrective action as needed.
- Partner with Training staff to design, deliver, and refine onboarding and ongoing training for supervisors and frontline staff.
- Promote a positive, trauma-informed, and mission-driven culture that values collaboration, accountability, staff wellness, and retention.
Staffing & Resource Management
- Partner with senior leadership and HR to recruit, hire, and onboard supervisors and program staff in alignment with staffing models and growth plans.
- Ensure staffing ratios, coverage, and workload distribution support timely and effective service delivery.
- Monitor productivity and utilization to balance quality care with financial sustainability.
Account Management & Stakeholder Collaboration
- Support the Senior Director in day-to-day account management with managed care plans and payors.
- Participate in regular meetings with health plans, providers, and community partners to review performance, resolve operational issues, and support program growth.
- Serve as an internal liaison between supervisors, frontline teams, and cross-functional departments including Quality, Analytics, Training, and Finance.
Growth & Continuous Improvement
- Ensure all referrals are addressed within contract-required timelines.
- Support program growth initiatives by identifying operational improvements, referral opportunities, and partnership strategies.
- Contribute to grant development, reporting, and special initiatives as assigned.
- Lead implementation of new initiatives, pilots, or process changes to enhance care delivery and outcomes.
Required Qualifications
- Bachelor’s degree in Social Work, Public Health, Health Administration, Human Services, or a related field; Master’s degree preferred.
- Minimum of three (3) years of progressive leadership or supervisory experience in care management, care coordination, or related healthcare or social service programs.
- Hands-on experience in care management or case management, preferably with high-acuity or underserved populations.
- Demonstrated knowledge of Medi-Cal, managed care environments, and community-based service systems.
Preferred Qualifications
- Experience leading ECM, CICM, or similar Medicare/DSNP or Medi-Cal managed care programs.
- Experience managing contracts, performance metrics, and program budgets.
- Bilingual and bicultural skills reflective of the communities served.
Skills & Competencies
- Strong operational leadership with the ability to translate strategy into execution.
- Excellent coaching, supervision, and team development skills.
- Ability to analyze data, manage dashboards, and use metrics to drive performance.
- Strong written and verbal communication skills, including the ability to present program performance clearly and succinctly.
- Collaborative leadership style with the ability to build strong relationships across teams and external partners.
- Highly organized, detail-oriented, and able to manage multiple priorities in a fast-paced environment.
- Comfort working independently while maintaining alignment with senior leadership goals.
Work Environment
- Hybrid role with a combination of remote work, in-person meetings, and occasional field engagement.
- May require occasional travel to support staff, partners, or program needs.
- Reliable transportation required.
- Auto liability insurance required with California limits.
Job Acknowledgement
The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions and perform any other related duties as assigned by their supervisor. Partners in Care Foundation reserves the right to alter work arrangements at any time with or without notice.