Director, Health Plan Case Management
United States /
Clinical Operations /
A bit about us:
We’re on a mission to change healthcare — how it’s paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being.
That’s why we’re gathering a whole bunch of smart, big-hearted people to create a new kind of healthcare company — one that combines compassion, health insurance, clinical care, and technology seamlessly.
We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.
Why Devoted: Make a difference... a big difference. You will have the opportunity, in a unique and dynamic culture, to be a part of something incredibly meaningful. We’re a disruptive startup with an inspiring mission. Learn and grow alongside our world-class team of healthcare, technology, and data leaders, dedicated to building a health plan and clinical services that care for everyone like they were our own mothers or fathers. Our team and board members have decades of experience in health policy, clinical services, data and technology. With their support, we look forward to building a health plan and clinical services that will give seniors easy access to the high-quality care they deserve.
A bit more about this role: We want to help members navigate the healthcare system in a better and safer way, and case management is critical to achieving this for our most vulnerable and complex members. The director for case management will therefore help build and lead the nascent case management group at Devoted. The director must have an understanding of what the most complex and vulnerable members need, and must be able to coordinate these services in a timely and cost effective manner. Specifically, the director will be involved in developing and overseeing the case management needs of the D-SNP population in Florida. The director will carry a case load, and will also be responsible for managing and mentoring other nurse case managers, as well as care coordinators who will help execute the case management work.
A day at Devoted could include:
- Providing leadership, coaching, and development to a team of nurses performing case management
- Reaching out to members with complex needs who would benefit from case management, and following up with some of the members you manage
- Providing direction and support to address escalated member challenges
- Developing and maintaining strong relationships with our provider and vendor partners, identifying inefficiencies and creating and implementing process improvement
- Partnering with Devoted’s data scientists to develop ongoing reporting and analysis to measure the productivity and outcomes of the case management department
- Serving as the subject matter expert for case management
- Counseling team members on CMS guidelines and MA regulations and to assure compliance
- Assuring case management is functioning to achieve member satisfaction and provider satisfaction
Attributes to success:
- Member / patient focused: you’re driven to help make dramatic improvements in the lives of the individuals you care for and have a track record of exceptional case management performance.
- Bring an interdisciplinary approach to case management that collaborates with pharmacists, social workers, behavioral health supports, providers, and crucially, the member and their caregiver.
- Love learning and helping others learn: you’re excited to bring your wisdom and coach others, but you’re equally energized to learn from other’s experience, and then keep improving how Devoted does case management as we learn more together.
- Bring a point of view on what case management practices work, which may not work as well, and how we can learn more about what does work.
- Excited about partnering with colleagues with different skills (such as software engineers and data scientists) to keep improving case management processes and learn from what we’re doing.
- Comfortable working in an organization that is growing and changing quickly.
- Enjoy moving back and forth between direct case management with members to helping us build out a case management team.
- Comfortable dealing with regulations and curious about how they’re changing.
Skills and experience:
- Registered Nurse with unrestricted license in Florida
- 3 years of experience doing case management at a health plan
- Experience managing a team
- Experience in providing clinical care
- Proven leadership, agility, and collaboration skills
- Understanding of CMS guidelines and MA requirements and how they’re changing
- Nice to have: experience working in a D-SNP plan
If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you!
Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.