Talent.com
Director of Care Management & Member Navigation
Director of Care Management & Member NavigationTRIARQ Health • Detroit, MI, United States
Director of Care Management & Member Navigation

Director of Care Management & Member Navigation

TRIARQ Health • Detroit, MI, United States
17 hours ago
Job type
  • Full-time
Job description

TRIARQ Health is a trusted partner to independent medical practices, enabling their independence and success in a value-driven healthcare ecosystem. We align with payers and enable practices with advanced technology, actionable insights, and tailored support that reduce administrative burdens, simplify operations, and drive sustainable growth—making specialists more attractive to members and referring providers.

We improve outcomes and affordability by proactively guiding members into evidence-based, conservative care pathways, ensuring they connect with high-value providers, avoiding unnecessary procedures, and enabling a coordinated care journey that balances quality, cost, and patient satisfaction.

Role Overview

The Director of Care Management & Member Navigation leads TRIARQ’s specialty care management programs, balancing strategic leadership with hands-on execution. This role oversees the design, implementation, and continuous improvement of care navigation, outreach, and engagement initiatives that guide members across their care journey—from diagnosis through recovery.

The Director will manage teams of therapists, nurses, care coordinators, and navigators, while also driving campaign execution, provider alignment, and payer reporting. A central responsibility is to implement multimodal engagement strategies, including one-to-many outreach tools, to improve patient adherence, provider compliance, and affordability outcomes.

Key Responsibilities

Program Design & Leadership

  • Build and scale care management programs across MSK, Urology, and other high-value specialties.
  • Develop standardized care pathways and plans with physician input; integrate payer medical policy into workflows to streamline utilization management and prior authorization.
  • Translate affordability and quality objectives into actionable interventions for care teams.
  • Collaborate with Member Experience, Program Management, and Provider Engagement teams to align strategies and priorities, ensuring care management programs are seamlessly integrated into operations and provider partnerships.

Operational Oversight & Execution

  • Lead daily operations of care management, including staffing, workflows, and queue optimization.
  • Design and execute one-to-many multimodal campaigns (digital, SMS, nurse calls, provider co-marketing).
  • Oversee member outreach scripts, provider playbooks, and navigator work queues to ensure closed-loop referral management and high-value care guidance.
  • Care Management and Navigation

  • Deploy early-intervention outreach at diagnosis and during key care transitions to keep members on conservative pathways.
  • Incorporate patient-reported outcomes (PROMs) and satisfaction measures to guide continuous improvement.
  • Optimize engagement cadence, messaging, and channels based on adoption rates, patient feedback, and affordability outcomes.
  • Provider Integration

  • Partner with PCPs, specialists, and allied providers (including PT) to align referral patterns, pathway adherence, and performance goals.
  • Conduct scorecard reviews and deliver feedback loops that drive provider accountability in value-based arrangements.
  • Manage escalation pathways by directing members back to the appropriate provider, ensuring timely follow-up, closed-loop communication, and accountability for ongoing care.
  • Analytics & Reporting

  • Use data-driven population stratification (early, chronic, episodic cohorts) to target care appropriately.
  • Track affordability, utilization, PMPM trend impact, pathway compliance, and referral adherence.
  • Provide regular reports to payers and internal leadership on engagement, outcomes, and financial performance.
  • Qualifications

  • Physical Therapist (PT) background strongly desired; RN or other clinical licensure would be considered.
  • Progressive experience in care management, population health, or value-based care.
  • Mission-driven orientation with a focus on patient-centered care and affordability.
  • Proven leadership of multi-disciplinary teams (PTs, RNs, navigators, coordinators).
  • Demonstrated experience with multimodal campaign execution for patient engagement.
  • Knowledge of payer-provider contracting and value-based arrangements.
  • Data-driven mindset with expertise in affordability and utilization reporting.
  • Excellent communication and collaboration skills with providers, payers, and patients.
  • Build-and-change mindset to create, manage, and problem-solve in a fast-paced environment.
  • Forward-thinking approach in the use of data and technology to enhance care management and member engagement.
  • Why Join TRIARQ?

    At TRIARQ, you will help transform specialty care by making healthcare more affordable, member-centered, and provider-aligned. Specialty utilization and spend represent nearly 50% of total healthcare costs, and we are focused on building a new care delivery model that aligns payers and providers to create better outcomes. This role is a unique opportunity to shape the future of healthcare while also rolling up your sleeves to execute—ensuring members feel supported, providers stay engaged, and payers achieve measurable affordability gains.

    You’ll be at the center of TRIARQ’s mission : guiding members through complex care journeys, enabling specialists to succeed, and proving that affordability and quality can go hand in hand.

    Create a job alert for this search

    Director Care Management • Detroit, MI, United States

    Related jobs
    Director of Nursing (DON)

    Director of Nursing (DON)

    Regency at Chene • DETROIT, Michigan, United States
    Full-time
    Are you looking for a nursing leadership opportunity with a growing organization? Regency at Chene has an exceptional opportunity for a Director of Nursing (DON) to join our team.As the Director of...Show more
    Last updated: 30+ days ago • Promoted
    Assistant Director, Nursing

    Assistant Director, Nursing

    Fox Run Village by Erickson Senior Living • Novi, MI, US
    Full-time
    Fox Run Village by Erickson Senior Living.Assistant Director of Nursing is responsible for clinical leadership and outcomes within our Skilled, Assisted Living, and Memory Care neighborhoods.A cult...Show more
    Last updated: 1 hour ago • Promoted • New!
    Site Director Opportunity in Commerce Township MI

    Site Director Opportunity in Commerce Township MI

    Ob Hospitalist Group • West Bloomfield, MI, United States
    Full-time +1
    Position : Site Director - Full-time.OB Hospitalist - Full-Time / Part-time / PRN.Hospital : DMC Huron Valley-Sinai Hospital. Location : Commerce Township, MI.DMC Huron Valley-Sinai Hospital.Recognized as ...Show more
    Last updated: 1 hour ago • Promoted • New!
    Director of Membership Services NewDetroit, MI 48226

    Director of Membership Services NewDetroit, MI 48226

    Detroit Lions • Detroit, MI, US
    Full-time
    Director of Membership Services.The Director of Membership Services role is responsible for the direct management of the Membership Services team, assuring that team members are executing assigned ...Show more
    Last updated: 30+ days ago • Promoted
    Home Health Physical Therapist - $80K-120K per year

    Home Health Physical Therapist - $80K-120K per year

    Graham Healthcare Group • Saint Clair Haven, MI, US
    Full-time
    Graham Healthcare Group is seeking a Home Health Physical Therapist for a job in St.Job Description & Requirements.At Mary Free Bed at Home, we’re looking to add to our extraordinary care team.Grou...Show more
    Last updated: 2 days ago • Promoted
    Director, Partner Enablement (Corporate Performance Management)

    Director, Partner Enablement (Corporate Performance Management)

    OneStream Software • Birmingham, MI, United States
    Full-time
    Range applies to US candidates only) + Benefits / Variable Comp / Equity - Range may vary based on experience.Vision, Medical, Life, Dental, 401K. OneStream Software is looking for a Director of Partner...Show more
    Last updated: 8 days ago • Promoted
    Pulmonary + Sleep Medicine- Medical Director of Sleep Lab & Respiratory Therapy

    Pulmonary + Sleep Medicine- Medical Director of Sleep Lab & Respiratory Therapy

    AMN Healthcare • Clarkston, US
    Full-time
    Job Description & Requirements.Pulmonary + Sleep Medicine- Medical Director of Sleep Lab & Respiratory Therapy.StartDate : ASAP Pay Rate : $430000. An award-winning hospital in Washington State is act...Show more
    Last updated: 30+ days ago • Promoted
    Director of Care Management & Member Navigation

    Director of Care Management & Member Navigation

    TRIARQ Health • Sterling Heights, MI, United States
    Full-time
    TRIARQ Health is a trusted partner to independent medical practices, enabling their independence and success in a value-driven healthcare ecosystem. We align with payers and enable practices with ad...Show more
    Last updated: 17 hours ago • Promoted • New!
    Admissions Director

    Admissions Director

    Regency at Livonia • LIVONIA, Michigan, United States
    Full-time
    Do you have a background in healthcare sales and marketing? If you enjoy working with seniors and their families to secure the best care for a post-acute stay, consider the role of Admissions Direc...Show more
    Last updated: 9 days ago • Promoted
    Mobile Wound Care NP - Breakaway from the office!

    Mobile Wound Care NP - Breakaway from the office!

    WoundRx • Richmond, MI, US
    Full-time
    Are you a highly autonomous Nurse Practitioner with a passion for advanced wound care and lean healthcare principles? How about are you a NP who loves seeing the world outside of the office walls? ...Show more
    Last updated: 13 days ago • Promoted
    Assistant Director

    Assistant Director

    The Goddard School of Rochester Hills, MI • Rochester, MI, US
    Full-time
    Community outreach opportunities.Affiliation with leaders in the early childhood education industry.The Goddard School located at : . East Auburn Road Rochester Hills, MI 48307.Assistant Director posi...Show more
    Last updated: 8 days ago • Promoted
    Associate Medical Director, Primary Care, Monroe, Wisconsin

    Associate Medical Director, Primary Care, Monroe, Wisconsin

    SSM Health • Monroe, US
    Full-time
    SSM Health is an Equal Opportunity Employer : .About SSM Health Monroe Hospital : .SSM Health is recruiting for a Primary Care Physician Associate Medical Director in Monroe, Wisconsin.Total Associate ...Show more
    Last updated: 8 days ago • Promoted
    Restaurant Delivery - Sign Up and Start Earning

    Restaurant Delivery - Sign Up and Start Earning

    DoorDash • Algonac, MI, United States
    Full-time +1
    DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a variety o...Show more
    Last updated: 2 hours ago • Promoted • New!
    Director of Philanthropy

    Director of Philanthropy

    Spraggins Recruiting • Plymouth, MI, US
    Full-time
    Director of Philanthropy Summary : Responsible for leading fundraising activities, donor engagement, communications, and marketing strategies to ensure long-term financial sustainability.This role c...Show more
    Last updated: 17 days ago • Promoted
    Patient Access Market Director-Detroit, MI- $15K Sign-on

    Patient Access Market Director-Detroit, MI- $15K Sign-on

    Conifer Revenue Cycle Solutions • DETROIT, Michigan, United States
    Full-time
    The Dir, PA Market is responsible for Conifer’s Patient Access day-to-day operating activities.This role is responsible for meeting all goals set for the operations and has total control of the ope...Show more
    Last updated: 30+ days ago • Promoted
    OBGYN Opportunity : Medical Director / Generalist or Non-Leadership Generalist – Suburb of Charlotte, NC

    OBGYN Opportunity : Medical Director / Generalist or Non-Leadership Generalist – Suburb of Charlotte, NC

    AMN Healthcare • Monroe, US
    Full-time
    Job Description & Requirements.OBGYN Opportunity : Medical Director / Generalist or Non-Leadership Generalist – Suburb of Charlotte, NC. StartDate : ASAP Pay Rate : $365000.An award-winning health system...Show more
    Last updated: 30+ days ago • Promoted
    Account Director - Chicagoland

    Account Director - Chicagoland

    OneStream Software • Birmingham, MI, United States
    Full-time
    Account Director - Chicagoland.US candidates only)+ Benefits / Variable Comp / Equity - Range may vary based on experience. Vision, Medical, Life, Dental, 401K.An Account Director is responsible for dri...Show more
    Last updated: 30+ days ago • Promoted
    Seeking Permanent Full Time Associate Optometrist Candidates Starting 2026

    Seeking Permanent Full Time Associate Optometrist Candidates Starting 2026

    Dr. Peter DiPasquale Optometry PC • Amherstburg, ON, CA
    Full-time +2
    Currently seeking : Future candidates for permanent full time associate optometrist, at Dr.Peter DiPasquale Optometry PC in rural Amherstburg, ON, Canada. Earliest start date is estimated at January ...Show more
    Last updated: 27 days ago • Promoted