About the RoleThe Supervisor – Care Management position is responsible for the direct daily supervision of care management activities of case managers and care coordinators for assigned North East market populations, including HMO and ACO members. This role ensures high-quality, cost-effective, and patient-centered care through effective supervision of care management operations, non-clinical staff, and interdisciplinary care coordination. The Supervisor will serve as a leader in maintaining compliance with health plan requirements, regulatory guidelines, and internal quality standards. This role reports to the Senior Manager, Care Management.
What You’ll Do
Leadership & Oversight- Provide day-to-day supervision of care management teams, ensuring adherence to ambulatory care management policies, procedures, and regulatory requirements.
- Supervises the delivery of clinical care management services across the continuum, supporting staff performance and clinical excellence.
- Ensure consistent application of policies and take corrective or disciplinary actions when necessary.
- Other projects and duties as assigned by Clinical Leadership team.
Program & Compliance Management- Monitor and support implementation of the Astrana Health care management process -- including training and documentation requirements.
- Review health plan reports to identify new members requiring coordination of care or targeted interventions.
- Ensure all care management activities are compliant with NCQA standards, CMS, health plan and state regulations, and internal protocols.
Clinical Oversight & Coordination- Support the development and review of individualized care plans and ensure integration of care strategies across disciplines.
- Engage with network PCPs, specialists, and vendors to ensure timely, appropriate care coordination and service utilization.
- Collaborate with internal departments including Utilization Management, Inpatient Case Management, and Ambulatory Care to ensure continuity across transitions of care.
Quality, Utilization & Financial Strategy- Conducts internal audits of ambulatory care management cases, provides feedback and coaching to staff as needed.
- Provide education and support to staff on documentation standards, best practices, and quality improvement opportunities.
- Assists with submission of deliverables for health plan audits.
Administrative & Staff Development- Conduct performance evaluations of care management staff, including audits of care plans, assessments, and documentation.
- Monitor staff attendance and ensure accountability to organizational expectations.
- Provide mentorship and training to foster a culture of excellence, collaboration, and continuous improvement.
- Oversee the hiring, onboarding, and training of new staff.
- Maintain the timekeeping and personnel records of staff.
- Other duties as assigned.
Qualifications
- High school diploma; diploma/certificate in management preferred.
- At least 2 years of case/care management experience in a medical group, IPA and/or HMO setting preferred.
You’re Great for This Role If- Knowledge of NCQA standards, Model of Care and Case Management requirements, CMS and state regulations, and HMO/ACO model structures.
- Strong communication, leadership, and critical thinking skills.
- Proven ability to work cross-functionally with clinicians, leadership, and administrative staff to drive outcomes.
- Experience in managing diverse teams and leading quality-focused initiatives.
- Skilled with the use of the Microsoft Office suite of products and the ability to use and effectively learn and navigate other computer systems.
Environmental Job Requirements and Working Conditions
- This is a remote position.
- Travel may be required based on business needs.
- The total compensation target pay range for this role is: $75,000 - $85,000. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information:The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Salary: 75000 - 85000 USD per year
