• Provide strategic and operational leadership for enterprise-wide complex case management programs serving clinically vulnerable Medicare Advantage members • Drive measurable improvements in quality outcomes, total cost of care, utilization efficiency, member experience, and risk adjustment accuracy • Partner closely with Clinical Operations, Medical Directors, Quality, Risk Adjustment, Network, Analytics, and Vendor Management to design and scale high-impact interventions • Ensure programs align with CMS requirements, MA Star Ratings, HEDIS, CAHPS, and evolving end-of-life best practices • Champion a member- and caregiver-centered approach, improving satisfaction and reducing care fragmentation • Collaborate with Medical Directors and Clinical leaders to ensure appropriate intensity of care, hospice and palliative referrals, and site-of-care optimization • Educate clinical teams on the intersection of complex care, end-of-life care, and risk adjustment accuracy without compromising care integrity • Establish performance standards, KPIs, and outcomes dashboards for complex case management programs • Mentor and develop clinical leaders, fostering a culture of accountability, compassion, and continuous improvement