Director of Clinical Care Management, LCSW
10 days ago
White Plains
Job Description Our client, a leading non-profit medical center in Westchester County, is seeking a Director of Clinical Care Management, LCSW, to lead a high-impact, multidisciplinary department focused on optimizing patient outcomes, enhancing operational efficiency, and ensuring appropriate financial reimbursement. This role carries 24/7 accountability and oversight for Access, Utilization Review, Denials and Appeals, Care Coordination, Discharge Planning, Clinical Social Work, Recovery and Disease Management, and Contracting. The Director will serve as a strategic resource to the Executive Team, partnering with internal departments, external payers, system partners, and community organizations to lead innovative care management strategies that are patient-centered, financially sustainable, and compliant with all regulatory requirements. This is a pivotal leadership role with a high-performing, mission-driven medical center known for its clinical excellence and commitment to the community. If you’re a strategic thinker who thrives in a collaborative environment and wants to make a measurable impact on patient care, this opportunity offers both purpose and growth. Key Responsibilities • Provide strategic and operational leadership for all Care Management services., • Manage daily operations, staffing, budgeting, and performance metrics for all areas under Clinical Care Management., • Lead, guide, and mentor Nurse Care Managers and Social Work Managers, ensuring alignment with departmental and organizational goals., • Develop and monitor department goals, policies, budgets, and quality metrics in line with the organization’s mission and strategic plan., • Ensure compliance with regulatory and accreditation standards across all care management functions., • Oversee the Care Management Dashboard, reporting, and key performance indicators (KPIs) including readmissions, denials, length of stay, and discharge planning effectiveness., • Facilitate interdisciplinary collaboration across the organization to support seamless transitions of care and optimal patient outcomes., • Participate in executive committees, performance improvement initiatives, and hospital-wide strategy development., • Maintain professional relationships with providers, payers, community partners, and vendors., • Lead the Utilization Review Committee and other assigned task forces., • Serve as a subject matter expert in managed care principles, clinical workflows, and value-based care strategies. Qualifications • Master’s in Social Work (MSW); LMSW or LCSW required., • CMAC or CCM certification preferred., • Minimum 1 year of acute care hospital experience., • At least 1 year in non-hospital-based healthcare settings (home care, insurance, outpatient, etc.)., • Prior experience managing a team or leading complex healthcare projects required., • Demonstrated leadership in human resource management, strategic planning, and change management., • Strong knowledge of:, • DRGs, Medicare regulations, and medical necessity criteria, • Patient rights, HIPAA, and regulatory compliance, • Clinical system assessments and risk stratification strategies, • Advanced capabilities in technical writing and data-driven program evaluation., • Strong interpersonal and communication skills with a collaborative and proactive leadership style., • High level of critical thinking and decision-making ability., • Proficiency in relevant healthcare IT systems and data analytics tools. Salary: The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.