Job Description

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We are seeking an experienced Care Delivery Manager (RN) with a strong background in Managed Long Term Care (MLTC), community health, and home care services . This leadership role is responsible for overseeing care management operations, supporting nursing standards of excellence, and ensuring the delivery of high-quality, patient-centered care to members throughout the continuum of care.

The ideal candidate will possess a combination of clinical expertise, leadership ability, care coordination experience, and a deep understanding of MLTC regulations and best practices . This individual will provide supervision, coaching, and professional development to nursing and care management staff while driving quality outcomes and member satisfaction.

Key Responsibilities

• Oversee the daily operations of the Care Management team, ensuring high-quality service delivery and compliance with organizational standards.
• Supervise, mentor, and support nurses and care management staff through coaching, performance management, and professional development.
• Ensure comprehensive member assessments, care plan development, and ongoing care coordination are conducted in accordance with MLTC requirements.
• Monitor clinical outcomes, quality measures, and member satisfaction to identify opportunities for process improvement and enhanced care delivery.
• Collaborate with interdisciplinary teams, physicians, community providers, and external agencies to coordinate member services and achieve optimal outcomes.
• Review complex clinical cases and provide guidance regarding care planning, utilization management, and service authorization.
• Ensure compliance with federal, state, MLTC, Medicare, Medicaid, and organizational regulations and policies.
• Promote best practices in community health, chronic disease management, transitional care, and population health initiatives.
• Participate in quality improvement projects, audits, and regulatory preparedness activities.
• Facilitate staff education and ongoing training to maintain clinical excellence and regulatory compliance.
• Analyze performance metrics and develop action plans to improve operational and clinical outcomes.

Qualifications

Required

• Active New York State Registered Nurse (RN) License.
• Bachelor's Degree in Nursing (BSN) required.
• Minimum of 5 years of nursing experience.
• Minimum of 2-3 years of supervisory or management experience.
• Previous Managed Long Term Care (MLTC) experience required.
• Strong community health, home care, care management, or case management background.
• Experience conducting clinical assessments and developing individualized care plans.
• Knowledge of Medicare, Medicaid, MLTC regulations, and care management best practices.
• Excellent leadership, organizational, communication, and interpersonal skills.
• Proficiency with electronic medical records and care management systems.

Preferred

• Master's Degree in Nursing, Healthcare Administration, Public Health, or related field.
• Certified Case Manager (CCM) or related certification.
• Experience managing interdisciplinary care teams.
• Quality improvement and utilization management experience.

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