Care Management Director

4 weeks ago


Topeka, Kansas, United States Sunflower Health Plan Full time
Job Title: Care Management Director

At Sunflower Health Plan, we are seeking a highly skilled and experienced Care Management Director to lead our care management team. This is a critical role that requires a strong understanding of healthcare operations, care coordination, and leadership.

Job Summary:

The Care Management Director will be responsible for overseeing the care management team, developing and implementing care management policies and procedures, and ensuring compliance with federal and state regulations. This role will also involve managing escalated and complex care cases, providing guidance to care management team members, and ensuring proper coordination and communication of medical service functions with other departmental functions.

Key Responsibilities:
  • Develop and implement care management policies and procedures to ensure compliance with federal and state regulations.
  • Oversee the care management team, including assigning, monitoring, and evaluating work assignments and caseloads.
  • Manage escalated and complex care cases, and provide guidance to care management team members.
  • Ensure proper coordination and communication of medical service functions with other departmental functions.
  • Develop and implement care management programs to facilitate the use of appropriate services and resources.
  • Set goals and objectives for the care management team to achieve cost-effective healthcare results.
  • Work with senior management to provide updates and insights on care management team goals.
  • Review long-term care member data to identify trends and improve operating performance and quality care.
  • Provide coaching and guidance to care management team members to improve member and provider experience and facilitate delivery of high-quality care.
  • Educate and provide resources for care management team members on key initiatives and member outreach.
  • Assist senior leadership with onboarding, hiring, and training care management team members.
Requirements:
  • Bachelor's degree and 5+ years of related experience.
  • Strong understanding of healthcare operations, care coordination, and leadership.
  • Excellent communication and interpersonal skills.
  • Ability to work in a fast-paced environment and prioritize multiple tasks.
  • Strong analytical and problem-solving skills.
What We Offer:

Competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.



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