Director, Care Coordination

Sutter Health

. Manage care coordination team activities, providing leadership and guidance .

Posted 11/12/2026full-timeOakland • California • United StatesLead💰 $206,690 - $330,699 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in care coordination, case management, and compliance with healthcare regulations, while effectively leading teams and managing complex projects to enhance patient outcomes and operational efficiency.

Highest-signal resume keywords

Care Coordination LeadershipCase Management ExpertiseRegulatory Compliance KnowledgeProject Management SkillsUtilization Management Analysis

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ManagementUtilization ManagementQuality Improvement ProcessesHealthcare Delivery KnowledgeBudget ManagementData AnalysisPatient Population Needs AssessmentStaff Training and DevelopmentComplex Case ReviewInterQual Criteria Knowledge

Soft Skills

Verbal CommunicationWritten CommunicationTeam LeadershipNegotiation SkillsProblem Resolution

Tools & Technologies

Microsoft PowerPointSpreadsheetsWord Processing Software

Certifications & Qualifications

California RN LicenseLCSW License

Industry Keywords

ACMA StandardsCMSA StandardsNASW StandardsManaged Care EnvironmentHealthcare RegulationsPatient ThroughputRisk ManagementClinical Oversight

About the role

Key responsibilities & impact

Manage care coordination team activities, providing leadership and guidance
Design, implement and evaluate staffing coverage based on case management ratios and patient population needs
Monitor department activities, communicate policies, evaluate performance, and provide feedback, coaching, mentoring and discipline
Develop department goals, objectives and action plans
Identify training needs and participate in staff training, orientation and new-hire onboarding
Ensure quality services through appropriate staffing, competency, training and education
Establish linkages between care coordination and internal entities and departments
Delegate duties and projects and develop department succession plans
Design, implement and direct care coordination processes to achieve program goals
Support senior leadership in entity-level change processes and population health management initiatives
Ensure compliance with accrediting, statutory, regulatory and facility-specific standards
Monitor high-risk complex cases and lead complex case reviews
Develop monitoring systems, measurements and evaluation tools for the care coordination team
Present the care coordination model to internal and external groups
Manage operational processes, budgets, resources and service projections
Facilitate complex clinical and financial decision-making requiring administrative approval
Design and interpret utilization and financial performance reports with analysis and finance departments
Track, analyze and present utilization management data and propose process improvements
Advise and educate staff on length of stay, readmissions, difficult discharges and patient throughput barriers
Develop and administer strategic plans aligned with Sutter Health goals
Perform staff rounds and monitor care activities
Communicate utilization issues and findings to senior leadership through reports, meetings and presentations
Work with payer communication, claims and billing staff to resolve complex claims and denials
Discuss coverage for medically necessary services with payers and providers
Collaborate on continuous quality improvement processes for care quality, customer satisfaction and financial performance
Develop and implement measurement and evaluation systems for program performance
Manage risk management issues and provide consultation on clinical, legal, regulatory and reimbursement matters
Guide case management and social work staff in resolving problematic situations and complaints
Coordinate clinical oversight for students and interns
Keep current on industry trends and research, and present best practices to leadership
Participate in educational forums, conferences and professional organizations

Requirements

What you’ll need

Bachelor's in Nursing OR Master's in Social Work OR Master's (or current enrollment with completion within 2 years) in Case Management or Health Administration with relevant acute hospital experience OR evidence of enrollment in Master’s Degree program and completion within 2 years
RN-Registered Nurse of California OR LCSW-Licensed Clinical Social Worker
12 years recent relevant experience
Knowledge of ACMA, CMSA & NASW Standards of Practice
Knowledge of available health care and community resources
Broad knowledge of health care delivery and case management within a managed care environment
Comprehensive knowledge of local, state and federal laws, regulations and professional standards affecting case management practice in an integrated delivery system
Verbal and written communication skills
Group presentation design and facilitation skills
Demonstrated ability to develop and manage complex projects
Working knowledge of InterQual criteria preferred
Ability to promote teamwork and effectively function in teams as a leader and team member
Ability to interact effectively with internal and external constituents using collaboration, negotiation and analytical problem resolution skills
Ability to work effectively in a fast paced environment, directing and managing multiple and complex projects
Analytical and mathematical skills
Demonstrated ability to implement continuous quality improvement processes and techniques, including benchmarking and outcomes measurements
Intermediate to advanced PC skills, word processing, spreadsheets and PowerPoint required
Strong problem resolution abilities and customer relation skills
Monday-Friday schedule; weekends as needed
Must hold California RN or LCSW licensure

Benefits

Comp & perks

Comprehensive benefits package
Eligible positions include a comprehensive benefits package