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Director of Clinical Care Management, LCSW

Director of Clinical Care Management, LCSW

Tal HealthcareWhite Plains, NY, US
1 day ago
Job type
  • Full-time
Job description

Job Description

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.

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    Director Care Management • White Plains, NY, US

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