Director, High Acuity Care

Key Responsibilities 

1. Care Ally Program Leadership & Clinic Partnership 

• Support end-to-end performance of the Care Ally Program, including panel management, scheduling, and hospital discharge intervention workflows across all clinics. 

• Serve as the executive escalation point for Clinic Managers on Care Ally performance, staffing, and workflow issues; resolve barriers that Managers and Care Allies cannot resolve independently. 

• Direct oversight of program performance domains: panel management, patient outreach and scheduling, admissions and readmissions, Transitional Care Management (TCM), and care management productivity. 

• Review performance trends and dashboards regularly; translate findings into action plans with clinic and care management leadership, and track results to close the loop. 

• Lead capacity planning, resource allocation, and staffing-coverage strategy across the Care Ally team in partnership with Clinic Managers. 

• Sponsor pilot programs and new workflow initiatives, and drive change management for adoption across clinics. 

2. Shared Decision-Making Program Leadership & Expansion 

• Direct the Shared Decision Making (Advance Care Planning) Program, partnering with Advanced Practice Providers (APPs) and Social Workers to deliver goals-of-care and advance care planning conversations for high-risk patients. 

• Build and execute an expansion strategy to scale the program's reach, staffing model, and clinic coverage in line with population growth and risk-contract requirements. 

• Establish standardized workflows, documentation standards, training, and best practices for APPs and Social Workers delivering Shared Decision Making conversations. 

• Define and monitor program KPIs, including advance care planning completion rates, documentation compliance, and downstream impact on utilization and cost. 

• Partner with Clinic Managers, palliative care, hospice, legal, and compliance stakeholders to ensure the program integrates cleanly into clinic operations and meets regulatory requirements. 

3. High Intensity Care (HIC) Patient Curation, Scheduling & Review 

• Oversee curation of the HIC patient population, applying risk-stratification and clinical criteria in partnership with clinic and care management leadership to identify patients who need this level of engagement. 

• Partner with Clinic Managers on scheduling strategy and visit capacity planning to ensure timely HIC patient access and appropriate clinician coverage. 

• Lead a recurring HIC panel review cadence with clinical and operational stakeholders to assess patient status, program fit, and outcomes. 

• Monitor HIC program effectiveness against cost, utilization, and quality targets, and adjust curation and scheduling approach based on results. 

• Ensure HIC operations align with payer program requirements and organizational policy. 

4. Cross-Program Leadership, Quality & Compliance 

• Build, coach, and develop a high-performing team across all three programs; set goals, manage performance, and support career development. 

• Ensure all three programs adhere to care management standards, quality requirements, payer contract terms, and organizational policy; lead audit readiness and documentation quality reviews. 

• Design, implement, and maintain standard operating procedures (SOPs), tools, and training resources that support consistency across clinics. 

• Report program performance, outcomes, and cost impact to the VP, Care Management and senior leadership; make data-driven recommendations for program strategy. 

Qualifications 

Education & Experience 

• Bachelor's degree in Healthcare Administration, Business, Nursing or related field required; Master's degree preferred. 

• 7+ years of experience in healthcare operations, care management, or population health, including 3+ years in a leadership role with direct reports. 

• Demonstrated experience in a Value-Based Care or risk-based contracting environment; experience with primary care operations strongly preferred. 

• Experience leading or scaling advance care planning, palliative, or shared decision-making programs is a plus. 

• Clinical licensure (RN or equivalent) preferred but not required, depending on background. 

Skills & Competencies 

• Proven ability to lead through influence with Clinic Managers and clinical stakeholders who are not direct reports. 

• Strong analytical skills; comfortable working in performance dashboards and translating data into action plans. 

• Program and project management skills, including the ability to scale a program (staffing, workflow, training) across multiple sites. 

• Excellent verbal and written communication skills, with the ability to present program performance to senior leadership. 

• Working knowledge of care management standards, TCM requirements, and payer/regulatory compliance in a Value-Based Care context.