Executive Director of Care Management

Company: Ohana Health Plan
Location: San Francisco
Posted on: February 1, 2025

Job Description:

About This OpportunityAs a key member of our leadership team, you will have the opportunity to shape the future of our care management department and make a lasting impact on the health and well-being of our members.We are seeking an experienced and visionary leader to oversee the care management team and develop strategies to improve member and provider experiences.Key Responsibilities

• Provide oversight and leadership to the care management team, ensuring the development, implementation, and monitoring of care management processes.
• Develop and communicate departmental goals and objectives to the care management team, ensuring alignment with organizational objectives.
• Lead and enforce care management policies and procedures, ensuring compliance with corporate, state, and National Committee for Quality Assurance (NCQA) standards.
• Provide subject matter expert guidance to senior leadership and care management team members on the latest care management policies, procedures, and standards.
• Review reports to ensure adherence to department budget and identify trends to effectively forecast.
• Implement care management strategies that align to organizational objectives, ensuring cost-effective healthcare results.
• Engage with onboarding, hiring, and training new care management team members to support future growth and strategy.
• Lead and manage process improvements for the care management team, presenting to senior leadership.Requirements
  • Bachelor's degree and 10+ years of related experience, including prior management experience.
  • Current state's clinical license preferred.

Keywords: Ohana Health Plan, San Jose , Executive Director of Care Management, Executive , San Francisco, California