Director, Case Management

Overview
Director of Case Management

• Full-Time, 40 hours per week.
• Monday- Friday; Must be willing to work variable hours.

Duly's Value-Based Care organization is dedicated to transforming healthcare delivery by emphasizing quality outcomes and patient-centric approaches.
Holistic benefits designed to help our team members flourish in all aspects of their lives, including:

• Comprehensive medical and prescription drug benefits that include medical coverage at 100% (after deductible) when utilizing a Duly provider.
• $5,250 Tuition Reimbursement per year.
• 40 hours paid volunteer time off.
• A culture committed to Diversity, Equity, and Inclusion (DEI) and Social Impact
• 12 Weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members.
• 401(k) Match
• Profit-sharing program

Responsibilities
Are you ready to challenge the expected to deliver the extraordinary?
Reporting to the VP, Population Health the Director, Care Management is responsible for executing initiatives that drive the evolution of value-based care. This position will be responsible for strategic and operational direction and oversight of Value-Based Care, Care Management team including care coordination, Case Management, disease management and transitions of care management. Focus on achievement of core KPIs. Interprets and implements care management standards for Duly Health and Care clients to ensure adherence to health plan, regulatory guidelines, and contractual obligations.
The Journeys and Adventures that Await
Execution of KPIs

• Drive clinical and operational results - monitor and track team performance with focus on delivering on Value-Based Care and Care Management core KPIs.
• Assist in defining reporting requirements for generating measure-related reports and collaborates with necessary enterprise-wide business areas to create reporting dashboards.

• Collaborate with enterprise-wide business areas to improve systems/processes for gathering, managing, and reporting Care Management data.

Leadership and Administration

• Provide direction and manage daily operations of the Care Management Team and act as a clinical resource.
• Oversight of the Care Management team, including interviewing and hiring employees and ensuring employee training needs are met.
• Conduct staff management activities, including performance evaluations, skill and career development activities, policy administration, coaching on performance management and behavior and employee relations.
• Meet regularly with direct reports to review cases and provide coaching if applicable.

• Develop, implement, and update educational resources to support the needs of the staff and clients.

• Oversee staff who serves as a patient advocate to ensure timely resolution of issues dealing with complaints and inquiries.

Collaboration and Communication

• Collaborate with leadership to determine and achieve performance targets.
• Collaborates with the VP, Population Health to develop and operationalize strategic plans for the Care Management department.

• Serve as a liaison between Duly and its key stakeholders to promote, improve and communicate initiatives related to Care Management.

Compliance

• Serve as a liaison with regulatory and accrediting agencies to ensure compliance with standards, as applicable.
• Participate with contracted managed care organizations as necessary to ensure compliance with health plan and regulatory standards, as applicable.

Qualifications
The Experiences You Bring

• Bachelor's degree in Nursing required.
• Active Illinois Registered Nurse (RN) License in good-standing.
• Active CCM certificate or wiling to obtain certificate within one year of employment.
• 7+ years of relevant work experience required.
• Must have 5 years of experience working within medical/surgical or ambulatory experience within healthcare setting.
• Value-based care experience highly preferred.