Job Title

Director of Case Management – Medicare (Hybrid | NYC) Location: Manhattan (2 days onsite / 3 days remote) Salary: $160,000 – $170,000 Full-Time | Leadership Role A well-established, mission-driven managed care organization in New York City is seeking a Director of Integrated Case Management (Medicare) to lead its Medicare Advantage and D-SNP population. This is a strategic and operational leadership role responsible for overseeing integrated care management teams, ensuring regulatory compliance (CMS, DOH, OMH), and driving high-quality, member-centered care delivery for complex Medicare populations. Key Responsibilities: Provide oversight of Medicare Advantage and Dual Eligible (D-SNP) populations Ensure adherence to Model of Care and regulatory requirements Lead and supervise clinical and non-clinical case management staff Oversee transitions of care and readmission reduction strategies Collaborate with UM, Quality, Data Analytics, and Customer Service Support STAR, HEDIS, and CAHPS improvement initiatives Drive operational enhancements and performance monitoring Qualifications: BSN required (Master’s preferred) Active NYS RN license 10+ years healthcare management experience 5+ years leadership experience (Manager level or above) 5+ years managed care leadership overseeing clinical staff Strong knowledge of CMS, DOH, OMH regulations This hybrid leadership role offers competitive compensation, strong benefits, and the opportunity to impact care delivery for complex Medicare populations in NYC. #AC1 #ACP