Job Summary
Position title: Vice President, Care Management
Job Summary: The Vice President of Care Management will provide strategic and operational leadership for Essen Health Care’s Care Management services across New York. This executive-level position is responsible for overseeing program performance, care delivery, regulatory compliance, quality outcomes, partner relationships, and the financial performance of the Care Management division.
The ideal candidate is an experienced healthcare leader with a strong background in care management, population health, and value-based care. This individual will ensure that Care Management programs operate efficiently, meet regulatory requirements, achieve organizational goals, and deliver measurable value to patients, partners, and the communities Essen serves.
Responsibilities
Care Management Leadership
- Provide strategic direction and oversight for Essen’s Care Management programs and services.
- Develop and implement initiatives that improve care coordination, patient engagement, health outcomes, and service delivery.
- Ensure Care Management programs are aligned with organizational priorities, population health objectives, and value-based care initiatives.
- Identify opportunities to strengthen and expand services based on patient, partner, and community needs.
- Serve as a strategic advisor to executive leadership on Care Management performance, opportunities, and challenges.
Operations and Program Performance
- Oversee day-to-day Care Management operations across Essen and its partner network.
- Establish consistent workflows, performance expectations, and quality standards across all programs.
- Develop scalable processes for program implementation, partner onboarding, staff training, and ongoing operational support.
- Monitor key performance indicators, service utilization, patient outcomes, and contractual requirements.
- Identify operational gaps and implement corrective actions and continuous improvement initiatives.
- Ensure appropriate staffing models and resources are in place to support program goals.
Quality and Regulatory Compliance
- Ensure compliance with applicable federal, state, and local requirements, including New York State Medicaid managed care and Care Management regulations.
- Partner with Compliance, Legal, and Clinical leadership to maintain program integrity and address regulatory requirements.
- Develop and monitor quality assurance processes, documentation standards, and audit-readiness initiatives.
- Ensure timely and accurate reporting to internal leadership, payers, regulatory agencies, and partner organizations.
- Promote high standards of patient-centered, culturally responsive, and coordinated care.
Partnership and Stakeholder Management
- Build and maintain strong relationships with primary care practices, healthcare organizations, payers, community-based organizations, and other strategic partners.
- Serve as the senior relationship owner for Care Management partners, ensuring effective communication, engagement, and performance.
- Collaborate with partners to address operational concerns, improve outcomes, and strengthen service delivery.
- Support the development, negotiation, and implementation of Care Management service agreements.
- Establish effective onboarding and support processes for new partner organizations.
Financial Management
- Provide oversight of the Care Management division’s budget, revenue, expenses, and overall financial performance.
- Monitor financial and operational performance across programs and partnerships.
- Identify opportunities to improve efficiency, manage costs, and strengthen program sustainability.
- Collaborate with Finance and executive leadership on budgeting, forecasting, pricing, and resource allocation.
- Provide regular performance reports and recommendations to executive leadership.
Team Leadership and Collaboration
- Build, develop, and lead a high-performing Care Management team.
- Establish clear goals, performance expectations, and accountability measures.
- Foster a culture of collaboration, innovation, quality, and continuous improvement.
- Collaborate closely with Clinical, Operations, Finance, Compliance, Legal, Human Resources, and Information Technology leadership.
- Mentor and develop leaders within the Care Management division while supporting succession planning and employee engagement.
Qualifications
Required Qualifications
- Seven or more years of progressive healthcare leadership experience in care management, population health, managed care, or value-based care.
- Demonstrated experience leading complex Care Management programs and multidisciplinary teams.
- Strong knowledge of New York State Medicaid managed care and Care Management regulations.
- Proven experience improving operational performance, quality outcomes, and patient engagement.
- Experience with budgeting, financial management, and performance accountability.
- Strong leadership, communication, analytical, negotiation, and relationship-management skills.
- Bachelor’s degree in healthcare administration, business administration, nursing, social work, public health, or a related field.
Preferred Qualifications
- Master’s degree in healthcare administration, business administration, public health, nursing, social work, or a related field.
- Deep knowledge of the New York City and Bronx healthcare markets and provider landscape.
- Experience working with health plans, provider organizations, community-based organizations, and value-based care arrangements.
- Experience developing and managing healthcare service agreements.
- Background overseeing multi-site Care Management or population health operations.
- Clinical licensure or relevant professional certification is preferred but not required.
