Job Details

Job Description:
We are seeking a highly accomplished Senior Director of Health Plan Care Management to lead and oversee the care management operations within a managed care organization. This role requires strategic leadership, operational expertise and a deep understanding of healthcare systems to ensure the delivery of high-quality member care. The successful candidate will provide direction and support to a department of approximately 40–50 employees, fostering stability and engagement through periods of significant change. The position involves assessing and optimizing the use of the HealthEdge platform, overseeing daily care management functions, and ensuring compliance with regulatory and contractual standards. The Senior Director will collaborate with internal and external stakeholders, monitor operational performance, and support staff development to promote operational excellence and continuity. This is a short term contract assignment for remote candidates. If you are local to the Denver area, there is a possibility for direct hire.

Responsibilities:

• Lead, support and stabilize a department of around 40–50 employees through significant change and uncertainty.
• Provide clear direction, establish priorities, maintain accountability and foster engagement to ensure continuity of operations.
• Assess and optimize use of the HealthEdge platform to enhance care management workflows, data utilization, staff productivity and overall system effectiveness.
• Oversee daily care management functions, ensuring effective coordination of member care across medical, behavioral health, provider and subcontractor networks.
• Ensure care management programs and workflows meet CMS, Medicaid, NCQA, state Department of Insurance and contractual requirements.
• Support audit readiness and implement corrective action plans when necessary.
• Partner with medical leadership, compliance, quality, technology and data analytics teams to address operational challenges and maintain alignment.
• Monitor key operational, quality, and productivity indicators, analyze data, and communicate findings and recommendations to senior leadership.
• Support staff development by providing training, resources and guidance necessary for effective performance.
• Monitor vendor performance, ensure contracted services meet operational, regulatory, and performance expectations.

Requirements:

• Bachelor’s Degree
• 7+ years of experience in healthcare or managed care administration
• 3+ years of supervisory and management experience
• Knowledge of regulatory and accreditation standards for health plans or healthcare systems (preferred)
• Demonstrated ability to manage people and processes effectively
• Strong leadership skills and ability to engage multidisciplinary clinical and non-clinical teams
• Excellent collaborative skills with the ability to interface with healthcare providers
• Knowledge of case management principles and strategies (preferred)
• Ability to develop and maintain effective internal and external relationships
• Proficiency in Microsoft Excel, including data analysis, pivot charts and data visualization

Pay Range:
The anticipated pay range for this position is $78.00 - $85.00 per hour. We understand salary is an important factor in a job search, and we encourage you to apply even if you feel that your desired compensation may fall outside of the listed range. The final pay for this position is determined based on several factors including but not limited to, relevant experience, skills and certifications, education and training, geographic location, market conditions, and internal equity. We are committed to finding the right candidate for this role and are open to discussing how your unique qualifications align with our needs.

Benefits:

• Medical insurance
• Dental insurance
• Vision insurance
• 401(k) retirement savings plan

Equal Opportunity Employer:
The Jacobson Group is committed to fostering an inclusive and equitable workplace that reflects the diverse communities we serve. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status or any other protected characteristic as defined by applicable law. We believe that diversity of thought, background and experience strengthens our team and drives innovation. All employment decisions are based on qualifications, merit and business needs. If you require a reasonable accommodation to complete the application process or participate in an interview, please contact us at HR@jacobsongroup.com or +1 (800) 466-1578 to make a request.

Refer a Colleague:
Do you know someone who would be interested in this project? Submit your referral directly by emailing the Jacobson contact listed above or submitting them through this form. If your referral is hired for a contract assignment and meets all other eligibility criteria, you will receive a referral bonus!

Contact:
Karrie Ruch
kruch@jacobsongroup.com