Vice President, Enterprise Care Management Operations - WellMed - DFW

WellMed, part of the Optum family of businesses, is seeking a Vice President, Enterprise Care Management Operations to join our team in Dallas or Fort Worth, TX. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you'll be an integral part of our vision to make healthcare better for everyone. At Optum, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The Vice President, Care Management is a senior clinical and operational leader responsible for the strategy, performance, and oversight of enterprise-wide outpatient care management and social work programs across multiple markets. This role provides leadership for integrated, clinic-based models serving complex and high-risk populations, with a strong focus on value-based care, Medicare Advantage, and whole-person care delivery. This position directs programs including complex case management, chronic disease management, behavioral health integration, and social work, ensuring a coordinated approach that addresses social determinants of health and leverages community-based interventions. In collaboration with operational leaders, the VP is accountable for program performance, alignment with organizational priorities, and execution of care management strategies. The role ensures compliance with evidence-based clinical guidelines and all applicable regulatory and accreditation requirements, including Medicare and NCQA standards. Additionally, the VP provides long-term strategic planning to integrate care management programs into the organization's broader mission, operational goals, and commitment to high-quality, patient-centered care The VP of Care Management works closely with the WellMed Leadership and operational teams to achieve the goals and objectives of the Care Management Program and to execute strategy through a matrix model across operations, affordability and clinical leadership.

Care Management Programs: Basic and Complex Care Management, Transitions of Care, and Social Work Designs and directs Care Management and Social Work program descriptions, work plans, program evaluations and overall Model of Care using best available literature and evidence Directs the development, planning and execution of continual process improvement efforts, policies, procedures, and regulatory compliance functions related to care management and social work activities Collaborates with physician leadership to execute the implementation of the care management programs as defined by Enterprise as well as OptumCare. Provides information/data to market leadership on an ongoing, regular cadence approved by leadership Promotes understanding, communication and coordination of all care management programs components with regions and their leadership Provides oversight and coordination for all activities related to delegated and regulatory requirements including annual health plan delegation audits as needed Drives adoption of best practices and trends for CM and SW activities Participates in health plan CMS audits as needed Monitors/analyzes metrics/data/trends and ensures areas needing attention are communicated to applicable stakeholders and action plans are put into place Develops operating budget as necessary and participates on various teams, committees and meetings at WellMed and OptumCare Designs