Supervisor-Complex Case Management (Full-time Remote, North Carolina Based)

Alliance Health•Fayetteville, NC

7h•Remote

About The Position

The Supervisor for Complex Case Management will provide supervision, coaching, and monitoring of the Complex Case Management team, a team of licensed clinicians responsible for coordinating care for members identified for Complex Case Management. The position will ensure that the Complex Case Management team performs work that aligns with Alliance’s CCM program description and NCQA guidelines. This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office may be required.

Requirements

Master’s degree in Human Services or related field and three (3) years of experience providing complex care management, case management, or care coordination to the population being served.
A license, provisional license, certificate, registration or permit issued by the governing board regulating a human service profession (examples include LCSW, LMFT, LCAS, LCMHC, LPA, RN) required.
Graduation from an accredited nursing school with Registered Nurse license and three (3) years of experience with at least two years of applicable experience providing complex care management, case management, or care coordination to the population served.
Leadership experience required.
Demonstrated knowledge of the assessment and treatment of mental health, substance abuse, intellectual and developmental disabilities.
Knowledge of legal, waiver, accreditation standards and program practices/requirements.
Knowledge of the Alliance Health service benefit plans and network providers.
Person Centered Thinking/planning
Detail oriented
Ability to independently organize multiple tasks, priorities, and to effectively manage an assigned caseload under pressure of deadlines.
Exceptional interpersonal skills, highly effective communication ability.
Ability to make prompt independent decisions based upon relevant facts and established processes.
Problem solving, negotiation and conflict resolution skills
Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) is required.

Nice To Haves

Master’s Degree from accredited Program in Nursing and Three (3) years of full-time, post degree experience providing care management, case management, or care coordination to members with Behavioral Health and/or Physical Health conditions.
Two (2) or more years leadership experience preferred.

Responsibilities

Work with Human Resources and Unit Director to maintain and retain a highly qualified and well-trained workforce
Ensure staff are well trained in and comply with all organization and department policies, procedures, business processes. and workflows
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
Actively establish and promote a positive, diverse, and inclusive working environment that builds trust
Ensure all staff are treated with respect and dignity
Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members
Work to resolve conflicts and disputes, ensuring that all participants are given a voice
Set goals for performance and deadlines in line with organization goals and vision
Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional development
Cultivate and encourage efforts to expand cross-team collaboration and partnership
Participate in the initiation, development, and maintenance of clinical protocols and other population-based programs, facilitating collaboration and consensus of multidisciplinary teams
Oversee the development of department specific goals and objectives ensuring alignment with NCQA and contractual requirements, system strategy, vision, mission, and values
Formulate, implement, and evaluate strategies for specialized staff education as it relates to member care, complex case management and plan of care development
Ensure members identified and/or referred to Complex Case Management are assigned timely to a Complex Case Manager
Review, validate and interpret risk stratification data and population health groups and recommend changes or adjustments to care management approach as needed
Utilize data systems to monitor process improvement and resource utilization
Knowledgeable of HEDIS measurements and population health within a complete care model
Utilize evidence-based practice to ensure quality outcomes for members
Utilize data to analyze needs of the members we serve, guide staff training development, identify resource needs and consistency of workflow implementation across disciplines
Ensure adherence to all Alliance Organizational Policies and Procedures and Care Management Desk Procedures
Make recommendations to improve department procedures and increase operational efficiency
Monitor trends and identify opportunities for enhancements in service utilization and implementation throughout the organization
Travel between Alliance offices, attending meetings on behalf of Alliance, participating in Alliance sponsored events, etc. may be required
Travel to meet with members, providers, stakeholders, attend court hearings etc. is required