Manager-Child And Adult Welfare Care Management (Remote, North Carolina Based)

The Manager of Child and Adult Welfare Care Management provides support, supervision, and development of DSS Care Management Supervisors within the DSS Care Management Department at all Alliance locations. The Manager will assist in building and overseeing an efficient Care Management system to support at risk youth in various programs, with a focus on those in DSS custody, members receiving adoption assistance, and former foster youth.

***This position is a provisional appointment meaning it is expected to have an end date within the next 12 to 18 months.***

This is a full-time remote opportunity. There is no expectation of being in the office routinely, however, the selected candidate must be available to travel in the community as needed.  The selected candidate must reside in North Carolina. 

Responsibilities & Duties

Staff Management and Development

• Work with Human Resources and Director of Child and Adult Welfare 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, and business processes
• Organize workflows and ensure staff understand their roles and responsibilities
• 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

Collaborate with External, and Internal Stakeholders

• Develop strong working relationships with providers and external stakeholders by scheduling ongoing opportunities to share feedback and collaborate, specifically with the Department of Social Services and Juvenile Justice in all Alliance counties
• Participate in local, regional, and state meetings as required
• Exercise conflict resolution skills to appropriately resolve issues with providers and external stakeholders
• Develop strong working relationships within Provider Networks Provider Network Evaluation, as well as the Medical Team by scheduling ongoing opportunities to share feedback, collaborate, and identify shared responsibilities for achieving program and organizational deliverables

Implement Recommendations for Continuous Quality Improvement

• 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
• Implement recommendations to improve department procedures and increase operational efficiency
• Monitor trends and identify opportunities for enhancements in service utilization and implementation throughout Alliance

Oversee Program Operations and Development

• Develop and support program operations in new Alliance regions, while adhering to Tailored Plan standards
• Participate in the initiation, development, and maintenance of clinical protocols and other population-based programs, facilitating collaboration and consensus of multidisciplinary teams as complete care is developed
• 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 plans of care
• Monitor and ensure compliance with Key Performance Indicators (KPI’s)
• Manage the team and stakeholders serving youth who are in need of placement/residential intervention to include to reduce the length of stay in inappropriate and crisis placements. Facilitate meetings with stakeholders serving/supporting this population. Manage data related to youth in need of placement. Work with Provider Network and other departments as appropriate to address gaps and barriers in the network

• Interact with members, families and the healthcare community as well as coordinate different teams to foster an exchange of ideas and promote team collaboration and learning opportunities

Oversee Documentation Maintenance and Reporting

• Maintain medical record compliance/quality
• Ensure timely documentation of Care Coordination activities as required by department policy and procedures
• Monitor completion of documentation in all systems to ensure data is entered timely and accurately
• Oversee the collection and delivery of data requests impacting program operations

Comply with Policies, Procedure, Processes, and Workflows

• Adhere to all Alliance Organizational Policies and Procedures and Care Management Desk Procedures

Minimum Requirements

Education & Experience

Graduation from an accredited school of nursing with Licensure as a registered nurse 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

Or

Master’s degree from an accredited college or university in Human Services and five (5) years post graduate degree 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.  

Must be licensed in North Carolina as a LCSW, LCMHC, LPA, LMFT or RN

Preferred: NACCM or CCM certification

Knowledge and experience collaborating with county departments of social services, department of juvenile justice, crisis response, and community-based treatment providers including training highly preferred.

Knowledge, Skills, & Abilities

• 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
• Strong verbal and written communication skills to interact with members, families and healthcare community
• 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 

Salary Range

81,375.00 to 135,625.00/Annually 

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.   

 An excellent fringe benefit package accompanies the salary, which includes: 

• Medical, Dental, Vision, Life, Long and Short Term Disability
• Generous retirement savings plan
• Flexible work schedules including hybrid/remote options
• Paid time off including vacation, sick leave, holiday, management leave
• Dress flexibility