RN Director Care Management Population Health - Remote in or Eastern time zone

Optum is seeking a Director of Care Management to join our Optum Care team. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone.

At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and erience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country.

Because together, we have the power to make health care better for everyone. Join us in improving healthcare through the power of people and intelligent technologies while Caring. Connecting. Growing together.

The Director of Care Management is a population health leader accountable for both financial and clinical performance in a full-risk environment, with significant responsibility for strategy, talent development, and value-based outcomes.

Key responsibilities include strategic leadership and oversight for the development, implementation, and management of comprehensive care management programs and wrap around services. This role is responsible for reducing avoidable utilization to annual targets and improving clinical outcomes of high-risk patients.

This position extends beyond day-to-day operations and staff management, requiring ownership of total cost of care performance, value-based contract success, and organizational capability development.

Region level oversight of care management programs, including complex care management, transitions of care, utilization management integration, behavioral health coordination, social determinants of health initiatives, and high-risk member interventions.

You'll enjoy the flexibility to work remotely
* from anywhere within the CST or EST time zones as you take on some tough challenges.

• Accountable for building a high-performing leadership team capable of scaling and sustaining results
• Partner with executive leaders, physicians, payers, analytics teams, and operational stakeholders to drive value-based care transformation
• Create leadership succession plans and establish a solid management pipeline
• Provide executive oversight of care management operations while empowering leaders to manage daily execution
• Represent care management in executive committees, payer discussions, and strategic planning initiatives

• Monitor and improve key financial metrics
• Own and drive performance against total cost of care targets and financial goals associated with full-risk populations
• Leverage data and predictive analytics to identify intervention opportunities that improve both clinical and financial outcomes
• Coach managers on performance management, strategic thinking, quality improvement, financial stewardship, and organizational leadership
• Develop performance dashboards and accountability structures for leaders and teams

• Ensure evidence-based care management practices are implemented consistently across programs
• Develop and execute the care management strategy supporting full-risk, capitated, shared savings, and value-based reimbursement models
• Lead initiatives focused on chronic disease management, high-risk populations, behavioral health integration, transitions of care, and health equity
• Design scalable workflows and operating models that optimize care management effectiveness and efficiency
• Ensure compliance with regulatory, accreditation, payer, and organizational requirements
• Drive a data-informed culture focused on outcome achievement rather than activity completion

Optum NY/NJ was formed in 2022 by bringing together Riverside Medical Group, Care Mount Medical and Pro Health Care. The regional alignment combines resources and services across the care continuum - from preventative medicine to diagnostics to treatment and beyond across New York, New Jersey, and Southern Connecticut. As a Patient Centered Medical Home, Optum NY/NJ can provide patient-focused medical care to the entire family.

You will find our team working in local clinics, surgery centers and urgent care centers, within care models focused on managing risk, higher quality…