Regional Care Management Director, Regions 1 and 2
About the position
The Regional Care Management Director will lead the care management team for Medicaid Regions 1 and 2 in North Carolina, focusing on integrated physical and behavioral health care for youth in foster care and adoption assistance. This role involves overseeing care management programs, collaborating with local agencies, and ensuring compliance with clinical standards to improve health outcomes for complex members.
Responsibilities
Provide oversight and leadership of Care Management and Care Coordination programs within two Medicaid Regions.
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Oversee the CFSP Care Management teams, including hiring, training, and evaluating direct reports.
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Set strategy and execute performance drivers aligned with contractual requirements and comprehensive care planning.
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Supervise Care Management Supervisors to implement clinical and non-clinical activities impacting healthcare quality and outcomes.
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Coordinate with North Carolina DHHS to align clinical programs with member needs.
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Develop metrics for monitoring program objectives and compliance with regulatory standards.
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Identify training priorities and develop population health strategies.
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Innovate to increase effectiveness and quality in care management programs.
Requirements
BA/BS degree and a minimum of 8 years of experience in a related field, including management experience in a managed care setting.
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Clinical, quality, and/or utilization management experience in a healthcare organization.
Nice-to-haves
Reside within assigned regions (Regions 1 and 2).
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Fully licensed clinician (e.g., LCSW, LCMHC, RN, LMFT).
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5+ years of Care Management/population health experience serving Medicaid beneficiaries.
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5+ years of experience working with children, youth, and families in the child welfare system.
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Management experience of clinical and non-clinical staff.
Benefits
Merit increases
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Paid holidays
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Paid Time Off
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Incentive bonus programs
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Medical, dental, and vision benefits
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Short and long-term disability benefits
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401(k) with matching
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Stock purchase plan
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Life insurance
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Wellness programs
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Financial education resources
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