Director of Care Management

Premier Home Health Care Services, Inc. is a leading established Home Health Care Agency. We currently have an opportunity for a Director of Care Management in New York City.

The Director of Care Management is responsible for providing management oversight and leadership to the Premier Clinical Team Managers and their teams. Director assures direct management of all Service Level Agreements (SLA) to ensure plan contracts are in compliance. The Director holds the managers/teams accountable for delivery of high-quality community-based member care through appropriate allocation of member services and resources. Director will be the lead interface between Premier and the plan partnership team. This role is responsible for assuring that the Managers and care management teams adhere to the contracted MLTC ‘s Program Policies and Procedures as outlined by NY DOH.

Job Responsibilities:

Supervise Clinical Team Managers by providing day to day operational oversight of both clinical and non-clinical processes and procedures.

Review Service Level Agreements (SLAs) and ensure all goals and metrics are met or exceeded.

Oversee and provides guidance to the Managers for all Audits required both internally by Premier and plan partners.

Provides clinical direction, guidance, and problem solving to Clinical Managers regarding member care plan and service authorizations.

Assures that CM Article 49 unit meets all MLTC benchmark metrics as outlined in the CM/UR QI plan.

Oversees and assures communication as the lead interface between Premier and plan partnership team to address all issues and brings resolution to all inquiries.

Cross Training for coverage of all Premier plan care management contracts as part of the leadership team.

Qualifications:

Minimum of a RN, BSN Preferred. Current, valid, and unencumbered license, certificate, or registration or credentialing as required.

Work Experience:

5+ years of Health Care Experience required, with at least 3+ years of supervisory level experience.

Case management: 5 years (Required)

MLTC: 5 years (Required)

Home care: 3 years (Preferred)

Management: 5 years (Required)

Medical specialties:

Geriatrics

Home Health

Benefits:

401(k)

Dental insurance

Employee assistance program

Employee discount

Health insurance

Life insurance

Paid time off

Vision insurance