Director of Operations - Care Management & Value-Based Care
Director of Operations - Care Management & Value-Based Care
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Job Description
Director of Operations Care Management & Value-Based Care
Location: Southfield MI (On-Site with Statewide Travel)
Employment Type: Full-Time
Lead Value-Based Care Across Michigan with EPIC Health
At EPIC Health we are leaders in delivering integrated value-based care to diverse patient populations. We challenge the outdated systems of healthcare and prioritize patient-centered solutions that drive real measurable impact. We are currently seeking a Director of Operations (DOO) Care Management & Value-Based Care to oversee and optimize the performance of our care management and value-based programs across all Michigan locations. Travel is required.
This senior leadership role will drive performance improvement regulatory compliance financial sustainability and team development across multiple service lines including:
- Chronic Care Management (CCM)
- Transitional Care Management (TCM)
- Remote Patient Monitoring (RPM/RTM)
- Behavioral Health Integration (CoCM)
- Annual Wellness Visits (AWVs)
- Advanced Primary Care Models (APCM)
- Population Health Initiatives
What Youll Do
Strategic Leadership
- Lead and manage all operational functions for Care Management and Value-Based Care programs.
- Develop and implement strategic workflows that support patient engagement risk stratification and quality performance.
- Collaborate with clinical teams provider groups and population health leaders to optimize care coordination and patient outcomes.
Operations Management
- Supervise department managers and frontline staff across all value-based care and care coordination programs.
- Oversee patient enrollment patient communication documentation workflows and reporting structures.
- Monitor and analyze key performance indicators including HEDIS STAR RAF and MIPS scores.
- Ensure CMS HIPAA NCQA and payer-specific regulatory compliance.
- Partner with finance teams to track cost savings shared savings and performance-based incentive programs.
Performance & Quality Improvement
- Lead readiness for audits payer reviews and compliance evaluations.
- Implement continuous improvement initiatives across all programs to drive clinical quality and operational efficiency.
- Manage relationships with ACO/MSSP partners third-party vendors and health IT teams.
Team Development & Training
- Provide leadership and mentorship to multi-disciplinary teams.
- Ensure ongoing staff training in clinical documentation motivational interviewing evidence-based care and care management best practices.
Cross-Functional Collaboration
- Work closely with providers finance IT and external partners to ensure alignment with quality operational and financial goals.
Statewide Oversight
- Travel to all EPIC Health locations throughout Michigan is required to ensure program implementation operational consistency and team development.
Additional Responsibilities
- Other job duties as assigned to support the evolving needs of the organization.
What You Bring
Minimum Qualifications
- Bachelors degree in Nursing Healthcare Administration Public Health or a related field.
- Minimum of 5 years in a senior operations role within care management value-based care or population health.
- Deep knowledge of CMS value-based care models (ACO REACH MSSP PCF etc.).
- Proficiency in care management tools HIE systems and EHR platforms (Athena preferred).
- Strong understanding of HIPAA NCQA CMS compliance and payer regulations.
- Expertise in data analytics health informatics and performance dashboards.
Preferred Qualifications
- Masters degree (MPH MHA MSN MBA or equivalent).
- Certifications in Case Management (CCM) Lean Six Sigma or Project Management.
- Experience implementing or managing programs like CCM APCM RPM CoCM and TCM.
- Prior experience with payer-provider partnerships risk-based contracts and shared savings programs.
Core Competencies
- Population health management and risk stratification
- Performance improvement and clinical quality
- Regulatory and payer compliance
- Operational planning and service line scaling
- Interdisciplinary team leadership
Performance Metrics
- Program enrollment and patient engagement targets
- Achievement of HEDIS STAR RAF and MIPS quality measures
- Cost savings and shared savings benchmarks
- Patient and provider satisfaction scores
- Successful audit outcomes and reporting accuracy
Application Requirements
Applicants will be screened based on the following:
- Minimum of 5 years in a senior operations role within care management or population health.
- Demonstrated success improving performance in value-based care initiatives.
- Educational background aligned with healthcare nursing public health or administration.
- Familiarity with CMS models payer contracts and audit readiness.
- Track record of operational excellence team leadership and multi-site management.
Why Join EPIC Health
At EPIC Health youll be at the forefront of care transformationleading programs that improve the lives of patients and elevate the way care is delivered. We are a mission-driven innovation-powered organization committed to breaking barriers in healthcare.
What We Offer
- Competitive salary
- Health dental vision disability and life insurance
- 401(k) retirement plan
- Generous PTO and paid holidays
- Professional development and leadership growth opportunities
Required Experience:
Director
Employment Type
Full-Time
