Director of Integrated Case Management / RN / Hybrid

Director of Integrated Case Management (ICM) – RN | Hybrid Schedule
Up to $170,000 + Excellent Benefits (including a pension plan!)
Full-Time | Permanent | Monday–Friday | 2 Days in NYC Office, 3 Days Remote
About the Organization
For more than 30 years, this mission-driven health plan has been committed to delivering high-quality care to New Yorkers. Serving the Bronx, Brooklyn, Manhattan, Queens, and Staten Island, the organization offers a range of comprehensive health coverage options. They take pride in building strong relationships with members, providers, and the communities they serve.
About the Role
We are seeking a dynamic Director of Integrated Case Management (ICM) to lead clinical and operational functions for the Medicare Advantage and Integrated Benefits for Dually Eligible (IB-Dual) population, also known as the Medicare Dual Eligible Special Needs Plan (D-SNP). Reporting to the Senior Director of Integrated Care Management, this role ensures compliance with CMS requirements, oversees daily operations, and supports staff in delivering high-quality, person-centered care that addresses members' medical, behavioral, and social needs.
Key Responsibilities

• Partner in developing and executing the strategic vision for the ICM department.
• Lead, supervise, and mentor a multidisciplinary team delivering care management for the Medicare line of business.
• Ensure adherence to CMS regulations, the Medicare Model of Care, and internal care management protocols (screening, assessment, implementation, evaluation).
• Oversee transitions of care, developing strategies to reduce hospital readmissions and support members in community-based settings.
• Lead implementation of quality improvement initiatives in collaboration with Quality Management, UM, and Data Analytics teams.
• Collaborate cross-functionally with internal departments and external partners on key projects and initiatives.
• Provide clinical input on Quality-of-Care concerns and support strategies to improve HEDIS, STAR ratings, and CAHPS scores.
• Ensure new hires receive effective onboarding and provide ongoing staff development and performance coaching.
• Monitor departmental performance, analyze trends, and implement data-driven process improvements.
• Represent the ICM team in organizational meetings and workgroups.
• Provide regular updates to the Senior Director on departmental operations and performance.

Qualifications
Education & Experience

• Bachelor of Science in Nursing (BSN) required; Master’s Degree in Nursing preferred.
• Minimum 10 years of healthcare management experience, including at least 5 years in a leadership role (Manager level or above).
• At least 5 years of experience managing both clinical and non-clinical staff in a managed care setting.
• Strong knowledge of CMS, OMH, and DOH regulations, with experience in care coordination models in managed care environments.

Licensure

• Active and unencumbered RN license in the state of New York is required.

RCM Health Care Services’ mission is to provide opportunities for qualified candidates across medical professions. We deliver timely results and have built a reputation of trust with our clients and candidates. Since 1975, we have been providing staffing solutions to many of the finest healthcare institutions across the nation and careers for thousands of candidates. As professional career opportunity matchmakers, we follow up and follow through to help our clients and candidates to reach their career and life goals. We proudly hold the Joint Commission Gold Seal of Approval as well.