Care Management Manager

Astrana Health

. Manage clinical services, including oversight of clinical policies, procedures, and daily activities of clinical team staff .

Posted 9/23/2026full-timeJohnston • Rhode Island • United StatesMid-LevelSenior💰 $100,000 - $150,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in clinical services management, including compliance with state and federal regulations, care management for high-risk populations, and effective team leadership. Proficient in training staff on clinical policies and quality measures to ensure positive patient outcomes.

Highest-signal resume keywords

Clinical Services ManagementCare Management ExperienceNCQA and HEDIS KnowledgeEffective Communication SkillsRhode Island RN Licensure

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Care ManagementUtilization ManagementAssessment and DiagnosisTreatment PlanningQuality Measures MonitoringData AnalysisPolicy ComplianceTraining and DevelopmentPerformance ManagementEmergency Management

Soft Skills

Attention to DetailProfessional Work EthicAbility to Thrive in Fast-Paced Environment

Tools & Technologies

Microsoft Office SuiteWordExcelPowerPoint

Certifications & Qualifications

Active RN LicenseLMSW LicenseLCSW LicenseLMFT LicenseLPC LicensePhDPsyD

Industry Keywords

Managed CareValue-Based CareBehavioral HealthHealthcare Delivery SystemsChronic ConditionsDisabilitiesIntegrated Care ManagementPatient OutcomesState and Federal RegulationsEmergency Management Policies

About the role

Key responsibilities & impact

Manage clinical services, including oversight of clinical policies, procedures, and daily activities of clinical team staff
Ensure adequate staffing and effective workload distribution
Train team members to serve populations with chronic physical and behavioral health conditions and various disabilities
Train Integrated Clinical Services staff on NCQA and HEDIS measures and processes
Ensure compliance with state and federal regulations, including HIPAA
Liaise with other business units regarding emergency management policies and processes
Monitor procedures and outreach/intervention efforts for positive patient outcomes
Ensure appropriate care planning, education, and interventions for at-risk members
Coordinate information exchange between behavioral health and medical providers for comprehensive care plans
Monitor data related to quality measures, trends, provider issues, service gaps, and patient needs
Evaluate care management programs and implement improvements

Requirements

What you’ll need

Bachelor's degree in Nursing or a related field, or graduation from an accredited School of Nursing
Rhode Island licensure required; independent licensure required
Active RN, LMSW/LCSW, LMFT, LPC, PhD, or PsyD license in the applicable state
Massachusetts RN license preferred
At least 3 years of care management and/or utilization management experience
In-depth knowledge of assessment, diagnosis, and treatment of individuals with complex needs
Strong understanding of care management, mental health community resources, and local healthcare delivery systems
Experience leading a functional area, managing cross-functional teams on large-scale projects, or providing direct supervisory leadership, including hiring, training, work assignment, and performance management
Effective written and verbal communication skills
Extensive experience with Microsoft Office Suite, including Word, Excel, and PowerPoint
Professional work ethic and strong attention to detail
Ability to thrive in a fast-paced environment
Passion for improving the lives of complex, high-risk patients and advancing value-based care
Experience supporting integrated care management programs for high-risk populations preferred
Experience working within managed care, health plan, or value-based care environments preferred

Benefits

Comp & perks

Full-time position supporting telephonic and in-home Care Management services for high-risk patient populations
Occasional local travel may be required to support business and patient care needs
Frequent use of a computer, telephone, and standard office equipment
Compliance with HIPAA, state, and federal regulations
Ability to work independently and collaboratively across multidisciplinary teams
Reasonable accommodations may be made for individuals with disabilities