Director, Care Management Jobs

Hello, we're Belong.

We partner with regional payers to deliver Medicare Advantage and Special Needs Plan products.

With a dual focus on data-driven, proactive clinical intervention and unwaveringly empathetic patient experience, Belong has completely reimagined health insurance for seniors and other Medicare-eligible individuals who have been disregarded and deprioritized for far too long.

We believe that only by recognizing individuals can we make communities strong.

Belong Health. Kinder, more supportive care.

The Role

As a Director of Care Management, you will be responsible for overseeing and managing the Belong Health customer service, clinical, and care management operations. You will report into the Senior Vice President of Clinical Operations and will be responsible for all relevant program development, implementation, and monitoring in accordance with business needs and State and/or Federal mandates. This position recommends, develops and implements initiatives, and evaluates outcomes, objectives, policies, and procedures related to care management and customer service performance and quality improvement.

Responsibilities

• Manage administrative healthcare costs and quality targets by using metrics to drive constant process improvement.
• Build high performance teams that are organized and staffed effectively.
• This position oversees efforts to improve member outcomes as measured by external and internal quality measurement programs.
• Use of internal and external benchmarks to drive high quality outcomes and efficient processes.
• Provide information and knowledge to the customer service, clinical and care management staff, including new or changing processes and workflows.
• Engage in continuous process and quality improvement activities to improve the effectiveness and efficiency of processes and programs.
• Achieve successful implementation of the clinical strategy and direction for the division.
• Provide oversight of and leadership with minimal guidance to the Belong Health Customer Service and Care Management staff.
• Drive and implement initiatives and activities to ensure member care and service needs are in place.
• Oversee an interdisciplinary customer service team (team lead and customer call representatives) and the clinical and care management team (administrative, pharmacists, team leads, nurses, social workers, and community health workers).
• Work as a liaison with internal and external organizations to assure lines of communication are in place for member engagement and the implementation of new initiatives.
• Ensure monthly auditing of clinical and non-clinical staff.
• Collaborate with other departments at Belong Health and partner organizations to improve health outcomes and quality measure performance.
• Ensure compliance with internal, state, and federal policies.

Requirements

• Experience with complex data systems.
• Supervision experience of teams, including, but not limited to hiring, development, annual performance review and administering corrective actions in a remote and physical setting.
• Demonstrated strategic thinking with strong collaboration skills to work effectively with a variety of external organizations and personnel.
• Experience as a mid-senior management in care management or other healthcare management
• RN and master's degree and a minimum of 3 years of job-related experience in a leadership role.
• Experience in process improvement, ability to devise innovative and practical solutions to solve problems.
• Must have a Care management certification.
• Problem-solving skills that can include emergency situations while communicating instructions and results in a brief and clear manner.
• 3 years of experience in Care Management and Managed Care experience.
• Bachelor's degree (BSN) with appropriate health care experience or master's degree in health or business-related degree.
• Understanding of health plans such as Medicare, Medicare Advantage, Medicaid and/or Managed Long-Term Care Plan (MLTCP).
• Must be located on the east coast to work east coast-specific hours.

Benefits & Perks

• Employer paid short-term, and long-term disability plans
• Fully covered memberships for EAP coverage
• Complimentary access to We Work
• Life and AD&D insurance access
• Bi-annual company summits
• HSA and FSA Plans (Dependent Care and Commuter)
• Employer 401k match up to 4% (Immediate vesting)
• Medical, dental and vision benefits employer contribution
• Generous PTO, including vacation days, sick leave and 11 national holidays
• Investor network support
• Meaningful paid parental leave for all caregivers, including a childcare stipend upon return from parental leave
• Thoughtfully curated monthly events including learning sessions, wellness sessions, and social events

Salary Range

• $130,000-$160,000

Physical Demands

These demands must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to sit, talk, or hear. There are no special vision requirements.
• Some travel to corporate locations, customer sites, and trade shows may be required to fulfill the position's requirements.

Work Environment

The work environment characteristics described here are representative of those encountered while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions

• The noise level in the work environment is usually quiet

Health & Safety

Belong Health and its partners require full vaccination for associates and select contractors who conduct work outside of their home on behalf of Belong Health and its partners. This applies to those who work within our facilities; interact directly with members and patients; attend in-person meetings or trainings; and/or represent Belong Health at events or volunteer activities. Medical and religious exemptions will be considered, and this policy will not supersede state or local laws

Belong Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.