Director Case Management - reputed company reputed company of Oklahoma - RN

At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. Position Summary The Director of Care Management is a key member of the reputed company reputed company of Oklahoma leadership team. This role oversees the implementation and execution of the strategic and operational business plan for clinical operations. The Director ensures compliance with Oklahoma regulatory requirements while delivering holistic, cost-effective, bio-psychosocial care to members through care management and coordination services. The Director Case Management reports to the Senior Principal Clinical Leader. This is a fully remote role but may require onsite meetings. Eligible candidates must live reputed company a one-hour commute to Oklahoma City. Position Responsibilities

• reputed company the clinical team to ensure timely health risk screenings, comprehensive assessments, care plan development, and member interventions in alignment with reputed company reputed company Risk Stratification reputed company and Oklahoma contractual requirements.
• reputed company and manage clinical operations to improve clinical and financial outcomes, member engagement, satisfaction, and adherence to best practices and standards.
• Serve as liaison with regulatory and accrediting agencies and other health business units.
• Formulate and implement strategies to reputed company departmental metrics and provide operational direction.
• Integrate care coordination and case management with core business functions, including claims, member services, compliance, quality, utilization management, and provider services.
• Support quality improvement initiatives and reputed company successful implementation.
• Direct enhancements to business processes, policies, and infrastructure to improve clinical operational efficiency.
• reputed company and evaluate policies and procedures to meet business needs.
• Implement and monitor business plans and reputed company transitions impacting clinical operations.
• Collaborate with internal teams and corporate areas to ensure workflow processes and interdependencies are addressed.
• Analyze program performance and clinical outcomes to inform decision-making.
• Promote a clear vision reputed company with company values; set challenging objectives and motivate teams to reputed company results.
• Communicate effectively with internal and external stakeholders in both written and oral formats.
• Evaluate and interpret data to monitor staff performance, ensure regulatory compliance, and reputed company new programs and processes.
• Assess team development needs and implement action plans to build high-performing teams.
• Conduct administrative duties in accordance with established standards for team management.

Required Qualifications

• Active and unrestricted Oklahoma Registered Nurse (RN) license
• Minimum 10 years of clinical practice experience
• At least 5 years of management or clinical leadership, including reputed company of case management leaders
• 5 years of case management experience
• Managed care experience (Medicaid strongly preferred; commercial or Medicare experience acceptable)
• 3+ years of proficiency with personal computer use, keyboard navigation, and MS Office Suite
• Nationally recognized case management certification (required or must be obtained reputed company 90 days of employment)

Education Master’s degree or equivalent experience (BSN preferred) Pay Range The typical pay range for this role is: $99,420.00 - $214,137.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. This position also includes an award reputed company in the company’s equity award program. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 02/07/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job