Director of Medicare Case Management
$160k - $170kRCM Health Care Services
Job Description Director of Case Management - Medicare (Hybrid | NYC)
Location: Manhattan (2 days onsite / 3 days remote)
Salary: $160,000 - $170,000
Full-Time | Leadership Role
A well-established, mission-driven managed care organization in New York City is seeking a Director of Integrated Case Management (Medicare) to lead its Medicare Advantage and D-SNP population.
This is a strategic and operational leadership role responsible for overseeing integrated care management teams, ensuring regulatory compliance (CMS, DOH, OMH), and driving high-quality, member-centered care delivery for complex Medicare populations.
Key Responsibilities:
This hybrid leadership role offers competitive compensation, strong benefits, and the opportunity to impact care delivery for complex Medicare populations in NYC.
#ACP
#LI-NS1
#LI-HYBRID
Location: Manhattan (2 days onsite / 3 days remote)
Salary: $160,000 - $170,000
Full-Time | Leadership Role
A well-established, mission-driven managed care organization in New York City is seeking a Director of Integrated Case Management (Medicare) to lead its Medicare Advantage and D-SNP population.
This is a strategic and operational leadership role responsible for overseeing integrated care management teams, ensuring regulatory compliance (CMS, DOH, OMH), and driving high-quality, member-centered care delivery for complex Medicare populations.
Key Responsibilities:
- Provide oversight of Medicare Advantage and Dual Eligible (D-SNP) populations
- Ensure adherence to Model of Care and regulatory requirements
- Lead and supervise clinical and non-clinical case management staff
- Oversee transitions of care and readmission reduction strategies
- Collaborate with UM, Quality, Data Analytics, and Customer Service
- Support STAR, HEDIS, and CAHPS improvement initiatives
- Drive operational enhancements and performance monitoring
- BSN required (Master's preferred)
- Active NYS RN license
- 10+ years healthcare management experience
- 5+ years leadership experience (Manager level or above)
- 5+ years managed care leadership overseeing clinical staff
- Strong knowledge of CMS, DOH, OMH regulations
This hybrid leadership role offers competitive compensation, strong benefits, and the opportunity to impact care delivery for complex Medicare populations in NYC.
#ACP
#LI-NS1
#LI-HYBRID
Vacancy posted 3 days ago
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