ConcertoHealth Inc. is the leading provider of specialized primary care and supporting clinical services for complex, frail, elderly, and dual-eligible patients. Operating exclusively in value-based agreements, ConcertoHealth provides high-touch, individualized care for patients, and deploys wraparound clinical resources to extend the reach of primary care practices. This comprehensive medical management solution, elevated by Concerto’s proprietary population health technology, improves overall healthcare quality and patient outcomes, benefitting payers and their provider networks. The company is headquartered in Irvine, Ca. For more information, please visit www.concertohealth.com.
The Director, Care Management Operations reports to the VP, Care Management and is a regional position that will support and guide regional care management functions in a fast paced, growth oriented population health organization. This dynamic role will support and manage a team to drive exceptional patient outcomes for a complex patient population using innovative technology solutions in a multidisciplinary care setting. This role will be accountable to achieve exceptional service and meet contract commitments to health plan partners and regulators, and drive project implementation activities and best practice policies and processes. The role will recruit and manage a range of care management professionals, including clinical and non-clinical positions, who collaborate to serve a diverse membership base.
This seasoned leader will monitor performance quality and performance metrics while also providing recommendations on operational design and efficiencies. The position will also collaborate with other stakeholders and functional areas.
3-5 years Health Plan care management experience required. Experience with MMP and/or DSNP programs required. Healthcare provider experience preferred. Ability to travel 15%, mostly within the state. Ability to work in a Windows based computing environment. Strong interpersonal and critical-thinking skills.
Education/Experience: RN required, Bachelor’s degree required, Advanced degree preferred.
Language Ability: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Math Ability: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
Computer Skills: Must be able to proficiently use Microsoft Office skills and clinical applications.
Sensitivity to Diversity – Interacting with others in ways that are socially appropriate and reflect an understanding of and respect for th