Care Management Director (Rn Or Lcsw)

We have an opportunity to join the Alliance as the Care Management Director (RN OR LCSW) in the Health Services Division.

WHAT YOU'LL BE RESPONSIBLE FOR

• Providing strategic management oversight in implementing, directing and monitoring the Alliance's Care Management functions, including Behavioral Health, Care Coordination, Care Management (Adult Complex Case Management and Pediatric Case Management inclusive of California Children's Services), in alignment with Medi-Cal, Knox-Keene and other regulatory and accreditation standards
• Directing the Care Management, acting as a subject matter expert, and providing executive level advice and guidance on Care Management issues and overall business operations
• Directing, managing and supervising Care Management Department staff

ABOUT THE TEAM

Coordinates care and empowers members to achieve their health and wellness goals through collaboration and by facilitating member relationships with community providers

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here.

• Knowledge of:
  • Complex practices, issues and theoretical principles related to community care coordination, including behavioral health
  • Principles and practices of Care Management and Care Coordination
  • Promoting and applying change management principles
  • Principles and practices of program development and project management
  • Principles and practices of supervision and training
  • Joint Commission, NCQA, URAC and/or other accrediting bodies
  • Medi-Cal and related policy and benefits-related Title 22 regulations
  • Medicare/MediCal Dual Eligibles from both the regulatory and Care Management perspective
• Ability to:
  • Demonstrate a collaborative management style, build rapport, and effectively manage internal and external business relationships including members of the medical community, community agencies, and board members
  • Make presentations and adjust communication style in order to facilitate collaboration and understanding
  • Direct, manage, supervise, mentor, train and evaluate the work of staff
  • Develop, plan, organize and direct programs and activities that are complex in nature and regional in scope
  • Provide leadership, facilitate meetings, and partner with and guide managers and employees in the resolution of issues that are complex and may have considerable impact
  • Attend in person meetings with community partners, providers, and hospitals
  • Review and assess overall department function, core work, goals and structure, develop and implement short- and long-term planning to achieve strategic plans, and complete an annual department assessment
• Education and Experience (RN):
  • Current and unrestricted license as a Registered Nurse issued by the state of California
  • Bachelor's degree in Nursing, Behavioral Health or Social Science
  • A minimum of ten years of relevant experience in the clinical aspects of managing a Care Management, Health Education, Utilization Management, or Quality Improvement program with demonstrated experience in process improvement and project management and including three years of management-level experience (a Master's degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying
• Education and Experience (LCSW):
  • Current and unrestricted license as a Licensed Clinical Social Worker issued by the state of California
  • Master's degree in Social Work
  • A minimum of eight years of relevant experience in the clinical aspects of managing a Care Management, Health Education, Utilization Management, or Quality Improvement program with demonstrated experience in process improvement and project management and including three years of management-level experience; or an equivalent combination of education and experience may be qualifying

OTHER DETAILS

• While this position is connected to one of our Alliance offices, we are in hybrid remote/in-office work environment right now and we anticipate that the interview process will take place remotely.
• Our Alliance office locations have officially re-opened as of May 2, 2022 and while some employees may work in full-time telecommute schedules, attendance at quarterly company-wide events or department meetings will be expected.
• Based on the nature of work, this position may require onsite presence, which is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below.
The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).