Program Director

We are seeking a Program Director to oversee the operations and clinical aspects of our Care Management Agency, delivering Medicaid Health Home services to individuals with chronic medical, behavioral health, and social needs. The ideal candidate will have both clinical expertise and strong management skills to ensure effective coordination of care and compliance with Medicaid regulations. This position is key to leading an interdisciplinary team that strives to improve health outcomes, optimize access to care, and ensure the program operates efficiently.

The Program Director will oversee all aspects of clinical care management, provide leadership to staff, ensure regulatory compliance, and monitor program outcomes. This individual will also collaborate with a wide range of stakeholders, including healthcare providers, social service agencies, and community partners, to ensure members receive comprehensive care tailored to their needs.

Essential Responsibilities:

• Program Leadership and Oversight: Provide direct supervision, leadership, and support to the care management team, ensuring high-quality care coordination for Medicaid members.
• Clinical Oversight: Supervise the development, implementation, and ongoing monitoring of comprehensive care plans tailored to the needs of individuals in the Health Home program. Ensure that care plans are evidence-based, person-centered, and aligned with Medicaid standards.
• Team Supervision and Development: Provide clinical supervision, mentorship, and leadership to the case management team. Ensure that team members have the necessary training, resources, and support to deliver high-quality care. Foster a collaborative environment focused on continuous learning, professional development, and staff retention.
• Quality Assurance and Compliance: Oversee quality assurance initiatives and ensure compliance with state and federal regulations, including Medicaid Health Home standards. Monitor and evaluate care delivery and program outcomes to ensure high levels of service quality, member satisfaction, and improved health outcomes. Lead activities such as chart reviews, audits, and performance evaluations to maintain regulatory compliance.
• Data Management and Reporting: Lead the compilation and analysis of program data, including health outcomes, service utilization, and member progress. Prepare regular reports for internal stakeholders and funding agencies to evaluate program performance and outcomes.
• Collaboration with Stakeholders: Build and maintain strong relationships with Health Home networks, healthcare providers, social service agencies, and other community partners. Work collaboratively to coordinate care across systems and ensure members have access to needed services, including medical, behavioral health, and social services.
• Crisis Management and Support: Serve as a point of contact for crisis intervention services, offering guidance and coordination during urgent situations. Ensure that appropriate clinical support is available to address immediate member needs.
• Program Development and Strategy: Collaborate with senior management to develop and implement strategic initiatives to enhance program operations, increase efficiency, and improve care outcomes. Identify opportunities for program improvement and lead efforts to integrate innovative approaches into the service delivery model.

Supervisory Responsibilities:

• Manage staff recruitment, work allocation, scheduling, and performance management, supporting professional development and staff engagement.
• Set performance goals, conduct regular performance reviews, and provide ongoing feedback and coaching.
• Ensure proper staffing levels and appropriate scheduling to meet program needs.
• Address staff concerns and provide guidance on complex clinical issues or challenging situations.
• Lead data collection and reporting efforts to assess program performance and contribute to continuous improvement efforts.

Qualifications:

• Required: Licensed Clinical Social Worker (LCSW), Licensed Master Social Worker (LMSW), or Licensed Mental Health Counselor (LMHC).
• A minimum of three years post-Master's experience in the emotional/behavioral assessment and treatment of individuals with complex needs (including those with chronic illness, mental health conditions, or substance use disorders).
• At least two years of supervisory or program management experience, including experience leading clinical teams in a health home or similar care management setting.
• Previous experience working within a Medicaid Health Home program or a similar care coordination model is strongly preferred..
• Proven ability to lead and motivate teams, work with diverse stakeholders, and manage relationships effectively. Excellent verbal and written communication skills.
• Strong ability to manage multiple priorities, analyze program data, and make data-driven decisions to improve program effectiveness and outcomes.
• Familiarity with electronic health record (EHR) systems and Medicaid management tools (e.g., MAPP, ePACES, PSYCKES) is highly desirable.
• Proven track record of driving program success and achieving desired outcomes.
• Bilingual skills are a plus.

Working Conditions:

• This position may require occasional evening or weekend work depending on program needs.
• May require travel within the service area for client visits, field audits, and meetings with external stakeholders.