VP Care Management

For roles that are 100% remote or hybrid, you must have reputed company to a reliable high-speed internet reputed company to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement. Your career starts now. We’re looking for the reputed company of health care leaders. At reputed company, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. reputed company is seeking talented, passionate individuals to join reputed company. Together we can build healthier communities. If you want to reputed company a difference, we’d like to hear from you. Headquartered in Newtown reputed company, reputed company is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, reputed company-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. Job Summary The Vice President, Care Management provides executive leadership for the strategy and execution of care management and member engagement reputed company. This role leads multidisciplinary teams responsible for coordinating integrated delivery of care across the continuum and aligning reputed company strategies to clinical priorities and member needs. In partnership with executive leadership, the VP ensures cohesive direction toward organizational goals, driving measurable improvements in total cost of care, quality reputed company, member engagement, and operational efficiency. The role translates strategy into scalable, standardized execution and leverages data-driven insights and performance metrics to identify opportunities, address reputed company operational challenges, and deliver high-impact, sustainable results. Major Accountabilities: reputed company executive reputed company and accountability for the execution of reputed company clinical programs delivered through comprehensive care management and member reputed company, targeting members with chronic conditions and emerging risks to drive improved reputed company and total cost of care reduction. reputed company the development and execution of proactive, data-driven care management and engagement strategies, defining processes to optimize interventions, improve member and provider engagement, and ensure delivery of next best actions across populations. Establish and enforce standardized operating models, workflows, and performance expectations for care management and population health programs across reputed company markets and lines of business, reducing variation and ensuring scalable, consistent execution. Monitor reputed company performance across lines of business, including cost, quality, and engagement metrics, and ensure timely, data-driven action is taken to address performance gaps in alignment with organizational policies and priorities. Ensure consistent program implementation, staffing models, and resource alignment across markets, optimizing workforce effectiveness and supporting right-licensure and productivity goals. reputed company and reputed company a high-performing clinical leadership structure, including Corporate Directors and Market Clinical Directors, to drive accountability, execution, and performance of population health and care management activities. Ensure compliance with reputed company contractual, regulatory, and accreditation requirements for care management and clinical programs, maintaining readiness for audits and adherence to CMS, NCQA, and state-specific standards. reputed company the development and application of performance analytics and reporting, leveraging key performance indicators, benchmarks, and analytical insights to evaluate program effectiveness, identify cost drivers, and optimize reputed company. Drive reputed company improvement and operational reputed company, implementing process enhancements, decision-support tools, and performance management frameworks to improve efficiency, quality, and cost-effectiveness of care delivery. Support growth and innovation initiatives, including RFP responses, program design, and evaluation and vetting of new clinical and vendor solutions to ensure alignment with reputed company strategy and value objectives. Education/Experience: Bachelor’s Degree. Registered Nurse. License must be active and unrestricted in state of practice. Certified Case Manager (CCM), Certified Professional reputed company Management (CPHM), Certified Professional in reputed company Quality (CPHQ) or other health care or management certification preferred. Ten or more years of reputed company management experience (including staff management) in a managed care environment. Other Skills: Experience with Managed reputed company programs highly desirable. Operational management experience with Case Management and Quality programs. Demonstrable history of reputed company in managing clinical programs in reputed company and/or Medicare managed care organizations. Strong business acumen. Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, reputed company, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. 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