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

Alliance Health•Durham, NC

2d•$77,868 - $99,282•Hybrid

About The Position

The Supervisor II-Care Management Support provides supervision and oversight to licensed or non-licensed Care Managers who support health plan members seeking behavioral health and/or physical health services with the Alliance Health Plan catchment area. The Supervisor oversees staff conducting assessment of member needs, linking members to network and community resources, reviewing care plans for quality control, and providing guidance to care managers on how to address members’ complex health and social needs. The Supervisor is responsible for ensuring fidelity to the Tailored Care Management model and Medicaid Direct Contract. This is a full-time hybrid opportunity. While there is no expectation of coming into the office routinely, the selected candidate must be available to report onsite to the Alliance Office (Morrisville, North Carolina) if needed to attend business meetings. The successful candidate will also be required to travel quarterly or as needed throughout Alliance’s catchment areas to meet with providers and/or other community stakeholders.

Requirements

Master’s degree from an accredited college or university in Human Services or licensure as an RN and (3) years of post-degree experience providing care management, case management, or care coordination to complex individuals with BH, I/DD or TBI. Must be fully or provisionally licensed in the State of North Carolina as a LCSW, LMFT, LCAS, LCMHC.
Graduation from an accredited school of nursing with licensure as a registered nurse and three (3) years of experience with at least two (2) years of applicable experience with the population served, including experience providing care management, case management, or care coordination to complex individuals with BH, I/DD or TBI. Must be licensed as a Registered Nurse in the State of North Carolina.
North Carolina residency required.
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 Medicaid and Innovations Service Array
Knowledge of applicable Federal laws, including Substance Abuse and HIPAA Privacy Laws.
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

Nice To Haves

Experience with managed care, population health management, and experience working for a provider serving persons with BH and/or PH needs.
NACCM, NADD, CBIS and/ 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 managers working with BH/IDD/TBI, Medicaid or State Funded 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 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
Ensure that the activities of the Care Management Support department are properly and professionally documented within electronic medical record platform per documentation standards for the Care Needs Screening, assessments, Care Plans, documentation notes, as well as internal and external email communication
Provide administrative oversight for team, identifying when escalation is necessary or when referral to Transition Coordinator or Community Health Worker is warranted and offering supervision on difficult cases
Ensure adherence to agency and departmental policies and procedures to facilitate the functioning of Care Management and compliance with agency, state and federal regulations
Participate in local, regional, and state meetings as required
Ensure care management activities are focused towards special health care populations
Promote efficient person-centered and whole person care management in compliance with all programs
Monitor trends and identify opportunities for enhancements in service utilization and implementation throughout the Alliance Health Plan catchment area
Provide oversight of case record reviews required by the Quality Management department
Participate in all related management and clinical team meetings as required
Develop and/or assist in the development of policies and procedures pertaining to the implementation and sustainability of the Tailored Plan system of services including the Department of Justice settlement
Analyze and monitor community capacity for service needs, service gaps, and the implementation of evidence based/best practices
Ensure appropriate distribution of member assignment
Oversee the implementation of a system-wide approach to improving the quality and accessibility of services and support for members served throughout the catchment area
Partner with community stakeholders to assess opportunities and barriers and achieve a seamless and coordinated service delivery system
Offer feedback as initiatives are developed
Provide supervision or co-monitoring of care manager activities to improve processes, workflows, monitoring and efficiency of services
Maintain working relationships with providers, community agencies, professionals and other stakeholders
Collaborate with other Alliance Departments to meet consumer and agencies goals
Make recommendations to improve department procedures and increase operational efficiency
Monitor trends and identify opportunities for enhancements in service utilization and implementation throughout Alliance
Adhere to all Alliance Organizational Policies and Procedures and Care Management Desk Procedures
Monitor staff compliance with all Alliance Organizational Policies and Procedures and Care Management Desk Procedures
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