RN Director, LTSS Clinical Care Management

Location: Remote in Texas; occasional travel to Austin or Houston for leadership meetings is required.

Salary: $133,700–$247,400 per year.

Company

hirify.global provides healthcare services focused on improving access, quality, and cost-effective outcomes for individuals, families, and communities.

What you will do

• Lead the development, implementation, monitoring, and continuous improvement of long-term care management programs.
• Manage RN managers and oversee staffing, caseloads, onboarding, training, competencies, and departmental operations.
• Set team goals, manage care management data and reporting metrics, and develop department budgets with senior leadership.
• Lead policies, procedures, audits, contract reporting, vendor oversight, and compliance with corporate, state, federal, and NCQA standards.
• Review member data to identify trends, care gaps, readmission risks, and opportunities to improve quality and operating performance.
• Develop clinical care pathways and strategic process improvements that enhance member and provider experience while controlling costs.

Requirements

• Graduate of an accredited school of nursing with 7+ years of related clinical nursing experience and current or prior management experience.
• Current state RN license or Compact Nursing License required.
• 4+ years of direct experience managing RNs in a managed care organization or state government agency preferred.
• Experience in value-based care management, including Child Welfare, Medicaid/Managed Care, CHIP, STAR Kids, or STAR Health programs.
• Advanced clinical knowledge, managed care expertise, and experience developing long-term service plans or care plans.
• Texas DFPS background check required. RUG certification is required for applicable Superior Health Plan roles and must be obtained within 90 days of hire when applicable.

Nice to have

• BSN degree.
• Experience with data analysis, health informatics, clinical reporting, and change management.
• Expert knowledge of healthcare industry regulations, policies, and standards.
• Knowledge of medication indications and side effects.

Culture & Benefits

• Remote work arrangement with occasional travel for leadership meetings.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Mileage reimbursement for required travel.
• Flexible work approaches that may include remote, hybrid, field, or office schedules depending on the role.
• Equal opportunity workplace focused on improving healthcare access and community health.