Director of Chronic Care Management & Clinical Operations

About This Role

This role involves leading and expanding chronic care management programs and clinical operations for a fast-growing healthcare organization. The Director will ensure high-quality patient care, optimize clinical workflows, and drive continuous improvement initiatives.

Responsibilities

• Design and launch clinical workflows for Behavioral Health Integration (BHI) and Wound Care programs
• Select screening tools (e.g., PHQ-9, GAD-7) and tissue viability protocols
• Author and maintain Standard Operating Procedures (SOPs) for specialized patient escalations
• Partner with IT/Product teams to customize EHR or CCM platform for tracking wound healing and mental health status
• Provide leadership to 5 Team Leads, conducting weekly audits to ensure targets are met
• Manage staffing ratios and recruitment strategies for team scalability
• Monitor and report on KPIs including Net Promoter Score (NPS), HEDIS quality scores, and ED utilization reduction
• Lead internal audits to ensure care plans are patient-centered and updated annually per CMS guidelines
• Act as the final clinical escalation point for complex multidisciplinary patient cases

Requirements

• Strong background in Nursing and Case Management
• Experience with Critical Care Medicine and Medicine practices
• Proven ability to develop and deliver effective staff Training programs
• Excellent leadership, communication, and organizational skills
• Ability to manage multiple priorities and optimize clinical operations
• BSN degree
• 7+ years in clinical care management
• 3+ years managing managers in a high-volume ambulatory setting
• Certified Case Manager (CCM) or equivalent
• Deep knowledge of CMS Fee-for-Service and Value-Based Care models

Qualifications

• BSN required; Master’s in Healthcare Administration (MHA) or Nursing (MSN) highly preferred
• 7+ years in clinical care management with at least 3 years managing managers in a high-volume ambulatory setting

Nice to Have

• Master’s in Healthcare Administration (MHA) or Nursing (MSN)
• Experience in chronic care management or clinical operations

Skills

* Required skills

Certifications