Director Care Management Operations
Southwestern Health Resources, Farmers Branch, TX, United States
Position Summary
The Director of Care Management Operations provides enterprise operational and clinical leadership for population-based care management programs, including complex care management and transitions of care. This role oversees interdisciplinary teams to ensure consistent, compliant, and patient-centered care coordination across the continuum while supporting value-based care performance, utilization management, and total cost of care goals.
Work location:
Hybrid – Expect onsite in Farmers Branch, TX, Tuesday through Thursday.
Position Duties
Provide strategic and operational oversight of population-based care management programs.
Align care management operations with enterprise quality, population health, and value-based care strategies.
Plan and scale care management programs to support new populations, products, and payer requirements.
Oversee coordination of care across the continuum for high-risk and complex patient populations.
Establish standardized care pathways, workflows, staffing models, and performance expectations.
Ensure adherence to evidence-based clinical guidelines and organizational standards.
Integrate whole-person care and social determinants of health into care management operations.
Ensure compliance with CMS, accreditation, and payer requirements.
Oversee audit readiness, accreditation processes, and corrective action plans.
Standardize policies, procedures, training programs, and clinical competencies.
Collaborate with analytics, quality, and finance teams to develop dashboards and performance reporting.
Monitor care management impact on quality, utilization, patient experience, and total cost of care.
Balance clinical outcomes with operational efficiency and resource optimization.
Serve as liaison to community agencies, post-acute providers, and social service organizations.
Build strong partnerships with physicians, clinical leaders, and internal stakeholders.
Support enterprise initiatives related to care coordination and clinical integration.
Lead, coach, and evaluate managers and interdisciplinary care management staff.
Recruit, develop, and retain a high-performing care management workforce.
Promote employee engagement, accountability, and professional development.
Other duties as assigned.
Qualifications
Education:
Bachelor's Degree in Healthcare Administration, Public Health, Nursing, Social Work, or related field required; Master's Degree preferred.
Experience:
8 years progressive experience in care management or managed care environments, including people management experience required.
Licenses and Certifications:
RN, LMSW, or LCSW required upon hire; CCM preferred.
Key Skills
People Management – oversight of department leaders in staffing, talent development, performance management, and resource planning.
Strategy Execution – translate organizational strategy into actionable department plans and align goals and operations.
Performance & Accountability – set clear performance expectations, use data to monitor results, and drive improvement.
Change Leadership & Operational Readiness – design change initiatives, implement new technologies/processes, and lead teams through transition.
Strategic Relationship Management – build and maintain relationships across departments, with senior leadership, and external partners.
Financial Resources & Stewardship – oversee departmental budget, identify efficiencies, and optimize resources.
Benefits
Comprehensive benefits package (health, dental, vision).
401(k) with employer match.
Paid time off.
Health insurance choices and dependent care spending account options.
Wellness programs.
Tuition reimbursement.
Student loan repayment program.
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Work location:
Hybrid – Expect onsite in Farmers Branch, TX, Tuesday through Thursday.
Position Duties
Provide strategic and operational oversight of population-based care management programs.
Align care management operations with enterprise quality, population health, and value-based care strategies.
Plan and scale care management programs to support new populations, products, and payer requirements.
Oversee coordination of care across the continuum for high-risk and complex patient populations.
Establish standardized care pathways, workflows, staffing models, and performance expectations.
Ensure adherence to evidence-based clinical guidelines and organizational standards.
Integrate whole-person care and social determinants of health into care management operations.
Ensure compliance with CMS, accreditation, and payer requirements.
Oversee audit readiness, accreditation processes, and corrective action plans.
Standardize policies, procedures, training programs, and clinical competencies.
Collaborate with analytics, quality, and finance teams to develop dashboards and performance reporting.
Monitor care management impact on quality, utilization, patient experience, and total cost of care.
Balance clinical outcomes with operational efficiency and resource optimization.
Serve as liaison to community agencies, post-acute providers, and social service organizations.
Build strong partnerships with physicians, clinical leaders, and internal stakeholders.
Support enterprise initiatives related to care coordination and clinical integration.
Lead, coach, and evaluate managers and interdisciplinary care management staff.
Recruit, develop, and retain a high-performing care management workforce.
Promote employee engagement, accountability, and professional development.
Other duties as assigned.
Qualifications
Education:
Bachelor's Degree in Healthcare Administration, Public Health, Nursing, Social Work, or related field required; Master's Degree preferred.
Experience:
8 years progressive experience in care management or managed care environments, including people management experience required.
Licenses and Certifications:
RN, LMSW, or LCSW required upon hire; CCM preferred.
Key Skills
People Management – oversight of department leaders in staffing, talent development, performance management, and resource planning.
Strategy Execution – translate organizational strategy into actionable department plans and align goals and operations.
Performance & Accountability – set clear performance expectations, use data to monitor results, and drive improvement.
Change Leadership & Operational Readiness – design change initiatives, implement new technologies/processes, and lead teams through transition.
Strategic Relationship Management – build and maintain relationships across departments, with senior leadership, and external partners.
Financial Resources & Stewardship – oversee departmental budget, identify efficiencies, and optimize resources.
Benefits
Comprehensive benefits package (health, dental, vision).
401(k) with employer match.
Paid time off.
Health insurance choices and dependent care spending account options.
Wellness programs.
Tuition reimbursement.
Student loan repayment program.
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