Supervisor II-Care Management Liaison (Full-Time Remote, North Carolina Based)

Alliance Health•Fayetteville, NC

3h•Remote

About The Position

Care Management Liaison Supervisor is a licensed healthcare professional who provides oversight to Care Management Liaisons, a team of licensed and non-licensed staff who support Alliance members working with external entities (Primarily Primary Care Offices and Provider Led Entities) by providing consultation, training and assistance to ensure quality member care. The key responsibilities will include oversight, training, process development, and monitoring of staff activities. This supervisor communicates and collaborates with internal and external stakeholders to resolve barriers to services and resources. They are accountable for maintaining effective and efficient team workflow and reporting requirements to Alliance leadership and the State. This position is full-time remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office may be required.

Requirements

Graduation from an accredited school of nursing with Registered Nurse license and five (5) years of experience with at least two (2) years of applicable experience with the population served, including experience with case management/discharge planning in one of the following settings: Acute care, home care, LTC care, Physician Office or Managed Care.
Master’s degree in human services from an accredited college or university and three (3) years post graduate degree experience with at least two years of applicable experience with the population served, including experience with case management/discharge planning in one of the following settings: Acute care, home care, LTC care, Physician Office or Managed Care.
Must have a valid, active clinical license as a LMFT LCSW, LCAS, LCMHC, LPA, or RN in North Carolina.
Knowledge and understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) and ICD-10 coding
Considerable knowledge of the MH/SUD/IDD service array provided through the network of the Applicant’s providers
Knowledge in the implementation of the 1915 (b/c) waivers and national accreditation is essential
Knowledge of and skilled in the use of MS Office Products including Outlook, Excel and Word
Detail-oriented and able to organize extensive amounts of clinical data, multiple tasks and priorities
Knowledge of research and best practice development in clinical practice
Knowledge of Utilization Management/Utilization review and other related areas
Knowledge of Tailored Plan standards or procedures
Knowledge of the NC Division of Mental Health, Developmental Disabilities and Substance Abuse IPRS Target Populations and Service Array
Knowledge of 1915(b) and NC Innovations Waiver
Knowledge of Medicaid and Innovations Service Array
Knowledge of applicable Federal laws, including Substance Abuse and HIPAA Privacy Laws
Knowledge of National Accreditation standards and regulations
Ability to effectively manage projects from start to finish
Ability to adapt and shift focus according to mandated changes and changing priorities within the department
Ability to access and interpret information and propose solutions to address issues and specific consumer needs and situations
High level of diplomacy and discretion
Ability to effectively negotiate and resolve issues with minimal assistance
Exceptional interpersonal skills
Ability to communicate effective orally and written
Ability to make prompt, independent decision based on relevant facts
Problem solving, negotiation, and conflict resolutions skills
Highly skilled at assuring that both long- and short-range goals and needs of the individual are addressed and updated, while also assuring through monitoring activities that service implementation is occurring appropriately
Knowledgeable of HEDIS measurements and population health within a complete care model

Nice To Haves

Two (2) years supervisory experience and CM or CCM certification 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 for care management working with BH/IDD/TBI and/or 1915i services
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 organizational goals, departmental strategic goals and the organization’s vision and values
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
Coordinate with internal and external partners to address member specific issues such as barriers, transitions in care, and access to resources
Assist external stakeholders through consultation, technical assistance and education to support Alliance members
Proactively identify and resolve member related issues to minimize care gaps and enhance member outcomes. This will involve, but not limited to, recognizing potential concerns revealed in data pulls, and alerts from internal departments or external stakeholders
Ensure that staff activities are properly and professionally documented based on current documentation requirements within electronic medical record platform as well as internal and external email communication
Provide administrative oversight for team, identifying when escalation is necessary or when collaboration is warranted and offering supervision on complex cases
Participate in all related management and clinical team meetings as required
Oversee the development of department specific goals and objectives ensuring alignment with system strategy, vision, mission, and values
Formulate, implement, and evaluate strategies for specialized staff education as it relates to member care, case management and coordination of support and services
Develop strong working relationships with providers and internal/external stakeholders by scheduling ongoing opportunities to share feedback and collaborate
Exercise conflict resolution skills to appropriately resolve issues with providers and internal/external stakeholders
Develop strong working relationships among the department and provide customer services with providers and stakeholders internal/external by scheduling ongoing opportunities to share feedback and collaborate
Utilize data systems to monitor process improvement and resource utilization
Utilize evidence-based practice to ensure quality outcomes for members
Ensure adherence to all Alliance Organizational Policies and Procedures and Care Management Desk Procedures
Ensure team adherence to agency and departmental policies and procedures to facilitate the functioning of the team and compliance with agency, state and federal regulations
Recommend 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