Tailored Care Management Director - Corporate

Tailored Care Management Director

Pathways to Life, Inc. — North Carolina (Corporate)

Full Time
· Exempt

Location flexible within North Carolina

Regular travel required ·

Hiring immediately

If you've supervised Tailored Care Management, you know what the Provider Manual doesn't tell you: that the 90-day assessment window is really a relationship window. That a care plan is only as good as the care manager who fought to get it signed. That the difference between a compliant program and a good one is whether someone at the top is paying attention to both.

We're looking for that person.

Pathways to Life is a certified Tailored Care Management provider serving NC Medicaid Tailored Plan members with behavioral health and substance use disorders, including members managing serious co-occurring physical health conditions. Our members live with the hardest combinations of circumstances the system produces — and they deserve a care management program built by someone who has actually sat in the chair.

This is a corporate leadership role. You do not need to live near any of our sites — you do need to be willing to travel across our service area to visit teams, host meetings, deliver training, and show up where the work is happening.

This role is open now and we are moving quickly.

• The team. Supervisors, care managers, and extenders. Hiring, training compliance, supervisory ratios, coverage during vacancy, and the culture that decides whether good people stay.

• The compliance floor. Certification standards, Tailored Plan contract terms, documentation integrity, audit response, and corrective action through to closure. When a reviewer asks a hard question, you're the one with the answer and the file to back it up.

• The clinical quality. Comprehensive assessments, Care Plans, multidisciplinary care teams, case conferences, transitional care, and access to clinical consultants for the cases nobody has seen before.

• The data. Beneficiary assignment files, claims and encounter data, acuity tiering, Patient Risk Lists, and quality measures — turned into decisions about who gets outreach first and where the program is quietly failing.

• The relationships. Tailored Plan and LME/MCO partners, primary care, hospitals, housing, DSS, justice partners, and the community organizations that make a referral real instead of a line in a chart.

This is not an entry point into Tailored Care Management. We need someone who can walk in and lead on day one.

• Prior Tailored Care Management experience at the Supervising Care Manager level or above. Non‑negotiable. You have supervised care managers, reviewed assessments and care plans, and carried real accountability for a TCM panel.

• Minimum 5 years in behavioral health, care management, care coordination, or health care administration, including at least 3 years supervising or leading.

• Master's degree in Social Work, Counseling, Psychology, Public Health, Healthcare Administration, Nursing, or a closely related field. A bachelor's in a human services field with substantial leadership experience will be considered.

• Working command of the NC Medicaid TCM Provider Manual — supervisory ratios, qualification standards, assessment and care plan time frames, qualifying contacts, and the six core Health Home services should already be familiar territory.

• Direct experience with the populations we serve: serious mental illness, serious and persistent mental illness, substance use disorder, and co‑occurring physical health complexity.

• Willingness and ability to travel regularly across our service area for site visits, team meetings, training, and partner engagements.

• Valid NC driver's license, reliable transportation,…