Tailored Care Management DirectorPathways to Life, Inc. - North Carolina (Corporate)
Full Time • Exempt
Location flexible within North Carolina
Regular travel required
• Hiring immediately
You've already done the work. Now come run the program.If you've supervised Tailored Care Management, you know what the Provider Manual doesn't tell you: that the 90-day assessment window is really a relationship window. That a care plan is only as good as the care manager who fought to get it signed. That the difference between a compliant program and a good one is whether someone at the top is paying attention to both.
We're looking for that person.
This is a corporate leadership role. You do not need to live near any of our sites - you do need to be willing to travel across our service area to visit teams, host meetings, deliver training, and show up where the work is happening.
This role is open now and we are moving quickly.
What you'll ownYou are the person accountable for the whole program - not a slice of it.
- The team. Supervisors, care managers, and extenders. Hiring, training compliance, supervisory ratios, coverage during vacancy, and the culture that decides whether good people stay.
- The compliance floor. Certification standards, Tailored Plan contract terms, documentation integrity, audit response, and corrective action through to closure. When a reviewer asks a hard question, you're the one with the answer and the file to back it up.
- The clinical quality. Comprehensive assessments, Care Plans, multidisciplinary care teams, case conferences, transitional care, and access to clinical consultants for the cases nobody has seen before.
- The data. Beneficiary assignment files, claims and encounter data, acuity tiering, Patient Risk Lists, and quality measures - turned into decisions about who gets outreach first and where the program is quietly failing.
- The relationships. Tailored Plan and LME/MCO partners, primary care, hospitals, housing, DSS, justice partners, and the community organizations that make a referral real instead of a line in a chart.
What we requireThis is not an entry point into Tailored Care Management. We need someone who can walk in and lead on day one.
- Prior Tailored Care Management experience at the Supervising Care Manager level or above. Non-negotiable. You have supervised care managers, reviewed assessments and care plans, and carried real accountability for a TCM panel.
- Minimum 5 years in behavioral health, care management, care coordination, or health care administration, including at least 3 years supervising or leading.
- Master's degree in Social Work, Counseling, Psychology, Public Health, Healthcare Administration, Nursing, or a closely related field. A bachelor's in a human services field with substantial leadership experience will be considered.
- Working command of the NC Medicaid TCM Provider Manual - supervisory ratios, qualification standards, assessment and care plan timeframes, qualifying contacts, and the six core Health Home services should already be familiar territory.
- Direct experience with the populations we serve: serious mental illness, serious and persistent mental illness, substance use disorder, and co-occurring physical health complexity.
- Willingness and ability to travel regularly across our service area for site visits, team meetings, training, and partner engagements.
- Valid NC driver's license, reliable transportation, current auto insurance, and ability to pass criminal background and healthcare exclusion screening.
What moves you to the top of the pile- NC clinical licensure - LCSW, LCMHC, LMFT, LCAS, LPA, Licensed Psychologist, or RN. (Required if you will also serve as a supervising care manager for any assigned member.)
- Experience with Innovations or TBI waiver coordination, 1915(i) services, or Transition to Community Living.
- You've been through a certification review, a Tailored Plan audit, or a corrective action plan - and came out the other side stronger.
- Comfort working with actual data files, not just dashboards someone built for you.
- Experience building a program from a small footprint into a durable service line.
Why nowWe are growing, and our members are already here. Every week this seat sits empty is a week our supervisors carry more than they should and our care managers get less support than they've earned. We would rather wait for the right person than hire the wrong one - but we are interviewing on a rolling basis and we are prepared to move fast for a strong candidate.
If that's you, don't wait for a polished cover letter. Send what you have.
Compensation & benefits- Salary range: $75,000 - $90,000, commensurate with licensure and TCM leadership experience
- Health, dental, and vision coverage
- Paid time off and holidays
- 401k
- Mileage reimbursement, licensure/CEU support, supervision toward licensure where applicable
How to applySend your resume and a short note about the TCM program you've led or supervised to Brittany Crumpler, COO - [redacted], subject line TCM Director Position. Questions before you apply are welcome.
