Director of Integrated Care & Patient Outcomes

About the Role
Join CareM Support in Albuquerque, NM as our new Director of Integrated Care & Patient Outcomes — a key role at the center of our clinically integrated care model. You'll partner across home health, hospice, primary care, and population health to improve transitions, outcomes, and experiences for medically complex patients.

This is a highly collaborative, system-facing role that supports all CareM-managed entities and interfaces with our value-based care network, Ensemble CIN.

Key Responsibilities

• Lead cross-division coordination across Home Health, Hospice, Palliative Care, Corus Medical, and Ensemble CIN
   
• Track, analyze, and report on patient outcomes, service appropriateness, and care timeliness
   
• Participate in IDG meetings, huddles, and QAPI sessions across multiple service lines
   
• Design and monitor Performance Improvement Plans (PIPs) that address systemic and service-specific quality goals
   
• Develop and deploy assessment tools to guide patient service recommendations
   
• Escalate care delivery trends or compliance issues to appropriate stakeholders
   
• Contribute to value-based care strategies through collaboration with population health teams
   
• Promote continuity and goal-concordant care across the patient journey
   

 What We’re Looking For

• 5+ years of experience in healthcare coordination, nursing, social work, or related clinical fields
   
• Deep familiarity with value-based care and clinically integrated network (CIN) models
   
• Demonstrated experience in QAPI processes and leading Performance Improvement Plans
   
• Strong systems thinking with a collaborative, interdisciplinary approach
   
• Skilled communicator able to engage with teams across disciplines and care settings
   
• Proficient in EHRs, data tracking tools, and care coordination platforms
   
• Ability to travel locally across CareM sites as needed (valid driver’s license required)
   

Why Join Us
At CareM, our mission is to bring out the courage in others — and that includes you. As part of the CareM Support team, you’ll have access to a strong mentoring culture, professional development opportunities, and the chance to shape integrated care delivery across New Mexico and Texas. We lead with trust, collaboration, and innovation — and we’re building something meaningful, together.