Director, Enhanced Care Management

This is a fully remote position, open to applicants in Arizona, +8 more states.

📋 Description

• Lead and manage the operations of Vynca’s Enhanced Care Management program.

• Design, execute, oversee, and administer the Enhanced Case Management Program.

• Supervise Clinical Managers, Clinical Consultants, Lead Care Managers, and ancillary staff.

• Refine and enforce program policies, procedures, standard operating procedures, and workflows.

• Manage daily ECM operations, including assessments, intakes, care planning, crisis management, and transition plans.

• Ensure adherence to CalAIM contract goals, objectives, regulatory obligations, data requirements, and service level agreements (SLAs).

• Maintain records and billing practices to meet established standards.

• Oversee staffing and provide staff training.

• Generate EHR reports as necessary.

• Manage claims submission, address denials, and oversee the receipt of payments.

• Represent the organization in interactions with the public, local businesses, employers, health plans, vendors, and regulatory bodies.

• Provide ECM reports to management and managed care plans.

• Develop strategic communication and address patient concerns.

• Oversee quality assurance initiatives and enhance client experiences.

• Create key performance indicators (KPIs) aligning team achievements with business goals.

• Manage profit and loss (P&L) and present business outcomes in monthly operation reviews.

• Tackle complex business challenges and adapt as necessary.

• Collaborate with department leaders, business development, and clinical operations to streamline referral management and patient onboarding.

• Assist the VP of Clinical Operations in crafting strategies for improved health outcomes, patient care, and cost management.

• Exemplify Vynca’s core values and ensure staff are familiar with the organization’s values and mission.

• Occasionally travel for leadership meetings, staff training, job responsibilities, and company events.

⛳️ Requirements

• A Bachelor's Degree is required, or a combination of comparable education and experience.

• Over 5 years of management experience in a similar field.

• Required experience in supervising a remote workforce and/or multiple sites.

• At least 3 years of experience in care management is required.

• Experience with Enhanced Care Management programs is highly preferred.

• A strong understanding of managed care programs is highly preferred.

• A proven, results-oriented business leader with experience in P&L responsibility.

• Proficient in Microsoft and Google applications, along with general computer literacy.

• Strong adaptability to work effectively in a collaborative and cross-functional remote environment.

• Must have access to a reliable internet connection.

• Capability to manage complex and multifaceted tasks and systems.

• Experience working with diverse populations culturally, ethically, sexually, and socio-economically.

• Experience collaborating within multidisciplinary teams.

• Willingness and ability to travel at least quarterly for leadership and team meetings, including staff training.

• Willingness and ability to support Pacific Time core business hours (Monday-Friday, 8:30 am-5 pm).

• Must be legally authorized to work in the United States.

• A background check is required prior to employment.

• Employees in patient, client, or customer-facing positions must be vaccinated against influenza.

🏝️ Benefits

• Medical, dental, and vision insurance.

• Income protection benefits.

• Flexible paid time off (PTO).

• Company holidays.

• 401k plan.

• Access to additional wellness benefits.

• Bonus opportunities.