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Job Description:

About the Role:

In your capacity as Director of Care Management you will be directly accountable for the delivery and oversight of Cityblock’s Care Management model for members in this NC Market. You will ensure Cityblock care teams and programs meet the needs of the individuals we serve and that the components are tightly articulated, operationally viable, and adherent to all regulatory requirements. You will work closely with the Care Team Leads, Community Nursing Managers, RN Care Managers , and Community Health Partners.

You will:

• Create audit tools and performed chart audits to provide feedback ensuring AMH and NCQA standards are met; review performance reports from payors and adjusted workflows as needed to meet goals.

• Manage KPIs, SLAs, data/ analytics and various other metrics to initiate and implement significant process changes and improvements related to delegation standards.

• Partner with practice operations to developed practice-oriented AMH tools and resources to support providers in comprehension and navigation.

• Provide direction and leadership to ensure Cityblock meets goals of enhanced patient care, improved population health, reduction of cost, and advanced health equity. This includes establishing, meeting, and continuously monitoring the goals and objectives of Population Health initiatives while maintaining alignment with the strategic goals and objectives for Cityblock.

• Collaborates with product development, marketing, and IT teams to continuously enhance systems and services to drive improvements and innovation organization-wide.

• Develop and maintains up-to-date policies and procedures; Conducts routine reviews and updates to ensure compliance and operational efficiency.

• Leverage clinical expertise in Care Management, Disease Management, and Population Health Management to support the organization in aligning the documentation platform with industry standards and best practices.

• Develops and manages operational initiatives with measurable outcomes.

• Provide guidance, coaching, and training around engagement, care planning, and longitudinal care. Bridge the contractual and state/federal requirements to Ensure compliance with contractual obligations and state / federal regulations.

• Ensure appropriate, compliant and timely completion of all elements of care management activities, including but not limited to: documentation of notes, completion of assessments and member actions plans, regular visits, appropriate follow-up after transitions, and high quality and trauma informed care.

• Partner with the Director of Nursing and Director of Market Operations to ensure:

• Clear performance tracking (metric design and dashboarding) is in place for care teams to understand key care model outcomes

• Timely and accurate reporting of care management activities to plan partner.

• Support the team’s ongoing professional learning, training, and clinical development.

• Develop programming and new initiatives based on member needs.

Requirements for the Role:

• Bachelor’s or, Masters preferred

• 5 Years’ of experience in a similar role managing a team of care managers.

• 5 years care delegation responsibilities

• 5 Years management experience

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Covid 19 Update - Please Read:

Cityblock requires those hired into this position to provide proof that they have received the COVID-19 vaccine. Any individuals subject to this requirement may submit for consideration a request to be exempted from the requirement (based on a valid religious or medical reason) on forms to be provided by Cityblock. Such requests will be subject to review and approval by the Company, and exemptions will be granted only if the Company can provide a reasonable accommodation in relation to the requested exemption. Note that approvals for reasonable accommodations are reviewed and approved on a case-by-case basis and availability of a reasonable accommodation is not guaranteed. This vaccination requirement is based, in part, on recently established government requirements. The requirement is also based on the safety and effectiveness of the vaccine in protecting against COVID-19, and our shared responsibility for the health and safety of members, colleagues, and community.

The COVID-19 pandemic has severely impacted the health and lives of people around the world, including the vulnerable populations Cityblock serves. As a healthcare provider, Cityblock holds ourselves to the highest standards when promoting the health and safety of those who we serve. Given that the COVID-19 vaccines are one of the most powerful tools to fight this disease and save lives, Cityblock is implementing a COVID-19 booster mandate for Washington, D.C. employees under the guidance of local/state mandates.

Medical Clearance (for Member-Facing Roles):

You must complete Cityblock’s medical clearance requirements, which include, but may not be limited to, evidence of immunity to MMR, Hepatitis B, Varicella, and a TB screen, or have an approved medical or religious accommodation that precludes you from being vaccinated against these diseases.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.