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CC
Community Choice dba Action Health Partners
Director of Clinical Services & Care Coordination
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Based on Washington data
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What they do
A Care Coordinator develops and manages patient care programs and handles patient cases. Keeps patients informed about their care options.
$73,888 / year median in Washington
Job Description
Position Summary The Director of Clinical Services & Care Coordination brings a clinical lens to the organization's community care hub and leads day-to-day delivery of care coordination services. The role is built around bringing clinical judgment and skill-building into a care coordination network staffed largely by non-clinical community partners.
It serves two integrated functions:
Clinical Advisor to the Hub. Serves as the organization's senior clinical voice for its Community Connect and Health Home models, advising the Executive Director, hub leadership, and network partners on clinical standards, escalation protocols, scope-of-practice questions, training, and the clinical integrity of care coordination pathways and workflows. Director of Direct Services . Leads day-to-day operations of the care coordination programs, builds clinical capacity and fosters program excellence. This exempt management position is a member of the organization's leadership team, exercises independent judgment, and may be delegated decision-making authority. Requires a minimum of four days per month onsite in East Wenatchee office, plus in-person attendance at key meetings, and regular travel throughout the service area. Essential Functions Care Coordination Program Leadership Direct daily operations of the Community Connect and Health Home care coordination programs across the service area. Directly supervise the Care Coordination Supervisor; monitor and evaluate the performance of care coordination program staff and supervisors; participate in personnel decisions including hiring, performance management, and position allocation. Monitor and adjust caseloads to balance client needs, contract requirements, and network capacity. Develop and implement program policies, procedures, and standard operating practices; establish procedures for new programs and services. Ensure documentation, data entry, and reporting meet program, payer, and contract standards. Clinical Advisement & Hub Support Serve as the designated clinical advisor for the community care hub, providing clinical consultation on pathway design, risk stratification, escalation criteria, and care coordination workflows. Advise non-clinical staff and community-based partner organizations on clinical questions arising in care coordination, including when and how to escalate client health and safety concerns. Develop, review, and maintain clinical protocols, standing guidance, and escalation procedures for hub and direct service operations. Ensure hub and program practices remain within appropriate scope of practice for clinical and non-clinical staff; provide guidance on delegation and supervision requirements. Support clinical components of contract deliverables, audits, accreditation, and certification activities (e.g., hub certification, payer requirements). Participate in clinical case review and consultation for complex or high-risk clients. Clinical Advisory to Workforce Development & Training Serve as senior clinical advisor to the organization's training function, supporting (not owning) the primary trainer on curriculum content, competency expectations, and continuing education for the care coordination network. Provide clinical subject-matter expertise to strengthen training materials, job aids, and escalation guides. Offer day-to-day clinical skill generation and coaching for care coordinators across the network, especially where community-based partners lack in-house clinical experience. Contribute clinical content and case learning to meetings of the full care coordination team. Serve as an accessible clinical resource for real-time questions from non-clinical staff and partner CBOs. Quality, Compliance & Reporting Interpret, advise on, and implement applicable program requirements, including Medicaid (Title XIX) and other state and federal program rules relevant to assigned services. Lead quality assurance and quality improvement activities, including file reviews, QA monitoring, and outcome measurement. Prepare and present program reports for the Executive Director, board or advisory bodies, funders, and oversight agencies. Support compliance with confidentiality, privacy (HIPAA), and data security requirements in clinical and care coordination workflows. Own incident review and support corrective action planning where indicated. External Relations & Partnership Represent the organization in daily business, community presentations, and meetings or conferences with partners, payers, and government agencies. Coordinate with community agencies and support the development of working agreements, referral relationships, and shared protocols. Serve as a clinical point of contact for state agency staff, managed care organizations, and network partners as assigned. Leadership & Administration Serve on the organization's leadership team and contribute to strategic planning, budgeting, and organizational development. Advise the Executive Director on program sustainability, staffing models, and funding allocation for assigned programs. Perform related duties as required. Minimum Qualifications Current, unencumbered Registered Nurse (RN) license in Washington State, or a multistate compact license with Washington practice authority. Bachelor's degree in nursing, public health, health administration, or a related field. Four (4) years of progressively responsible management or supervisory experience in a healthcare, care coordination, or community health setting. Working knowledge of Medicaid programs and community-based service delivery. Ability to pass required background checks. Preferred Qualifications Experience with community care hub, Community Connect, Health Home, or similar community-based care coordination models. Experience developing training, continuing education, or workforce development for multidisciplinary or non-clinical teams (e.g., community health workers, care coordinators). Experience with Title XIX / LTSS, Health Home, or similar Medicaid care coordination programs. Experience in quality improvement, program evaluation, or accreditation/certification processes. Familiarity with rural and multi-county service delivery. Knowledge, Skills & Abilities Sound clinical judgment and the ability to translate clinical standards into practical guidance for non-clinical staff. Strong supervisory and coaching skills; ability to manage supervisors as well as front-line staff. Ability to interpret contract, regulatory, and program requirements and operationalize them. Strong written and verbal communication, including report preparation and public presentation. Proficiency with standard office software and program data systems; ability to learn payer and state data platforms. Ability to manage competing priorities across programs with independence and discretion. Working Conditions Hybrid schedule with a minimum of four days per month onsite in East Wenatchee; additional onsite presence expected for key meetings. Regular travel throughout the service area and occasional statewide travel for meetings or training. Valid driver's license, reliable transportation, and proof of insurance required.Pay:
$100,247.00 - $113,917.00 per yearBenefits:
Dental insurance Health insurance Health savings account Paid time off Vision insuranceEducation:
Bachelor's (Preferred)License/Certification:
RN License (Preferred)Work Location:
In personBenefits
- Paid Time Off (PTO)
- Professional Development
- Health Insurance
- Dental Insurance