Senior Director, Case Management & Outcomes Performance

The Senior Director, Case Management & Outcomes Performance will provide strategic direction and oversight for all BHPS case management activities, ensuring high-quality, member-centered, cost-effective care while aligning case management strategy, clinical outcomes, and utilization excellence. The role will lead the development, monitoring, and improvement of performance metrics related to clinical outcomes, utilization, throughput, readmissions, denial prevention, length of stay, member satisfaction, and total cost of care. The Senior Director will also serve as the primary internal liaison between BHPS Clinical Operations and market-facing teams on matters related to case management and outcomes performance.

Requirements

• Bachelor's degree in Nursing, Social Work, or a related clinical field required.
• Master's degree in Nursing, Social Work, Healthcare Administration, Public Health, Nursing Informatics, or Business Administration strongly preferred.
• Active, unrestricted clinical license required (RN, LCSW, LMHC, or equivalent).
• Certified Case Manager (CCM), ACM, or equivalent case management certification required.
• 8–10+ years of progressive healthcare leadership experience, including substantial experience in case management, utilization management, or care coordination.

Benefits

• 401k Matching
• Retirement Plan
• Generous Paid Time Off
• Tuition Reimbursement
• Relocation Assistance