Director of Medical Management

  • Compensation: $150,000 - $165,000
  • Required Qualifications: RN, 3+ years of managed care leadership
  • City/State: Chicago, IL

One of the fastest-growing IPAs in Southern California is searching for a Director of Medical Management!

This full-time position requires a Ilinois RN license, strong clinical knowledge, and years of managed care leadership experience.

This is your chance to be a part of a growing organization founded by one of the most successful Physicians in IL.  

You can expect a Monday-Friday, 8am-5pm schedule and very generous benefits: Yearly bonuses, 3 weeks PTO, paid holidays, Medical/Dental/Pharmacy, Life Insurance, 401k matching and more.


  • Development and implementation of care management and utilization management policies and procedures to ensure compliance throughout the region and consistency throughout the network.
  • Maintenance of all Medical Management programs to ensure that patient care maximizes quality and continuity by utilization of appropriate resources.
  • programs across the regions, and the integration of these programs within the IPA model.
  • Monitors closely and analyzes all inpatient and outpatient reports and identifies trends; Makes recommendations regarding interventions to improve all resource management.
  • Develops and coordinates strategies for ensuring the delivery of care in the most appropriate setting.
  • Ensures that contracted providers are used and collaborates with contracting department to obtain new contracts with preferred providers based upon specific quality and utilization criteria.
  • Monitor all high-risk/high-cost patients and oversees cross-regional high-cost areas of Care Management.
  • Monitors provider referral patterns for appropriate utilization of specialty and ancillary services.
  • Initiates organizational and system changes to improve departmental staffing efficiency and effectiveness, and care management program outcomes within the region.
  • Identifies, develops and oversees the educational needs of the Care Management providers and staff including the implementation of an extensive orientation program, cross-training and proactive approach to Care management.

Minimum Qualifications:

  • Bachelor’s degree from a four-year college
  • Current Ilinois RN license
  • 3+ years as a Manager or Director of Case Management, UR, or UM at a health plan, medical group, IPA, or MSO
  • Proven working knowledge of Medicare and/or Medicaid regulations
  • Case Management Certification is plus but not required  

Compensation is dependent upon education and experience.