Manager- Integrated Health Engagement (Remote, North Carolina)

Alliance Health•Durham, NC

4h•$91,192 - $116,270•Remote

About The Position

The Manager- Integrated Health Engagement leads and supports interdisciplinary care management teams to ensure the effective delivery of integrated, whole-person care. This role is responsible for overseeing daily operational workflows, supervising frontline staff, monitoring team performance against KPIs, and implementing clinical and operational strategies for Care Management of High-Risk Pregnancies, Complex Case Management, CM Consultants and Personal Care Services. This is a full-time remote opportunity. There is no expectation of coming into the office routinely, however, the selected candidate must be available to report onsite to the Alliance Office (Morrisville, NC) for business meetings as needed.

Requirements

Bachelor’s degree from an accredited Nursing program with five (5) years post graduate degree experience with at least two (2) years of applicable experience with the population served. Knowledge of Medicaid, managed care, and integrated care models is required.
Or Master’s degree from an accredited college or university in Human Services and three (3) years post graduate degree experience with at least two (2) years of applicable experience with the population served.
Must have a valid, active RN license in North Carolina.
Must have three (3) years supervisory experience.
Ability to supervise, coach, and motivate individual contributors and interdisciplinary teams.
Knowledgeable of the Tailored Plan and Medicaid Direct Transformation.
Knowledge of care management workflows, clinical documentation, and quality improvement processes.
Ability to interpret operational data and KPIs to drive team performance.
Knowledge of research and best practice development in clinical practice for maternal health
Strong organizational, interpersonal, and professional communication skills.
Ability to manage multiple priorities and lead small-scale project implementations.
Proficiency in Microsoft Office Suite and Care Management platforms (e.g., Jiva).
Ability to adapt and shift focus according to mandated changes and changing priorities within the department.
Ability to effectively negotiate and resolve issues with minimal assistance.
Problem solving, negotiation, and conflict resolutions skills.

Nice To Haves

ACM or Certified Case Manager (CCM) certification
Additional relevant clinical, care management, quality, or leadership credentials
Supervisory experience in complex case management, maternal health/high-risk pregnancy support, Medicaid Managed care, Behavioral Health, Community Health, population health or human services preferred

Responsibilities

Supervise and support interdisciplinary teams (e.g. care managers, care coordinators) through coaching, workload planning, and performance management
Monitor team productivity, caseload distribution, and daily operational performance against department standards
Ensure staff adhere to established workflows, documentation standards, and time-sensitive engagement strategies
Facilitate regular case reviews, supervision, and team meetings to support clinical and operational excellence
Ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements
Work to resolve conflicts and disputes, ensuring that all participants are given a voice
Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional development
Implement and oversee the integrated care model within assigned teams, ensuring evidence-based practices are utilized in member care planning
Monitor the quality and accuracy of member assessments, care plans, and interventions to ensure alignment with clinical standards
Assist in the refinement of clinical workflows and the integration of new tools or protocols into the care management platform
Monitor department KPIs and team-level metrics to identify trends, gaps in service, or opportunities for improvement
Support quality audit activities and participate in staff remediation or performance improvement planning as needed
Ensure team compliance with NCDHHS requirements, Medicaid regulations, and Alliance Health policies
Support the execution of assigned projects, including the implementation of new workplans and the management of project-specific workflows
Lead frontline change management initiatives to ensure new business processes or technology updates are effectively adopted by the team
Assist in the development of departmental goals and the tracking of project milestones
Serve as a primary point of contact for internal and external stakeholders (e.g., providers, community partners) regarding daily operational needs
Communicate team performance findings, operational challenges, and resource needs to the Director of Integrated Health Engagement.
Collaborate with other leadership to ensure consistent implementation of workflows across different disciplines
Ensure program operations align with NCDHHS requirements, Alliance Health policies, regulatory expectations, program workflows, documentation standards, quality goals, and performance accountability measures
Ensure staff are well trained in and comply with all organization and department policies, procedures, and business processes
Adhere to all Alliance Organizational Policies and Procedures and Care Management Desk Procedures