Care Management Director

SUMMARY 

The Care Management Director provides supervision and oversight to Care Managers who support BH/IDD Tailored Plan members. The Director oversees staff conducting assessment of member needs, linking members to network and community resources, developing and monitoring plans of care, and addressing the barriers which may be interfering with member's desired outcomes for a community-involved quality life.

RESPONSIBIITIES

Program Development

-Lead the development of the Tailored Care Management program with support from the team of senior leaders who have been working on this effort.

-Review and understand AYN's Care Management Agency (CMA) application and the NCDHHS requirements for CMAs.

-Participate in the technical assistance process.

-Develop policies and procedures for the program.

-Develop working relationships with key community partners, including clinical consultants and social services providers addressing social determinants of health.

-Develop a training curriculum for Care Management staff.

Supervise and Develop Staff

-Work with Human Resources to acquire and retain a highly qualified staff team.

-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 to ensure compliance with agency, 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. 

Supervise Unit Operations

-Ensure that the activities of the Care Management Department are properly and professionally documented within electronic medical record platform for the Care Management Comprehensive Assessment, Care Plans, documentation notes, as well as internal and external email communication.

-Provide clinical oversight for team, identifying when escalation is necessary or when referral to an integrated health consultant is warranted and offering supervision on difficult cases.

-Ensure adherence to agency and departmental policies and procedures to facilitate the functioning of the Care Management and compliance with agency, state and federal regulations.

-Participate in local, regional, and state meetings as required.

-Promote efficient person-centered and whole person care management.

-Provide oversight of reviews required by the Performance Improvement department.

-Participate in all related management and clinical team meetings as required.

-Analyze and monitor agency and community capacity for service needs, service gaps, and the implementation of evidence based/best practices.

-Ensure appropriate distribution of client assignment to Care Managers based on needs and risk stratification.

-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 Customer Service

-Maintain positive working relationships with agency colleagues, other providers, community agencies, professionals and other stakeholders.

-Collaborate with other AYN Departments to meet consumer and agency goals.

Support Continuous Quality Improvement

-Make recommendations to improve department procedures and increase operational efficiency.

-Monitor trends and identify opportunities for enhancements in service utilization and implementation.

-Ensure completion of required outcome instruments.

Minimum Qualifications

A master's-level fully Licensed Clinical Social Worker (LCSW), fully Licensed Clinical Mental 

Health Counselor (LCMHC), fully Licensed Psychological Associate (LPA), fully Licensed Marriage and Family Therapist (LMFT), or licensure as an RN; and three years of experience providing care management, case management, or care coordination to the population being served. 

Special Requirements

Valid Driver's License

KNOWLEDGE, SKILLS & ABILITIES

-Person Centered Thinking/planning

-Knowledge of Medicaid basic, enhanced MHSUD, and waiver benefits plans

-Knowledge of the NC Division of Mental Health, Developmental Disabilities and

-Substance Abuse IPRS Target Populations and Service Array

-Knowledge of 1915(b) Waiver

-Knowledge of Medicaid Service Array

-Knowledge of applicable Federal laws, including Substance Abuse and HIPAA Privacy Laws.

-Knowledge of National Accreditation standards and regulations

-Knowledge of and skilled in the use of Motivational Interviewing

-Knowledge of LOC process

-Knowledge of Tailored Plan standards and procedures

-Knowledge of using assessments to develop plans of care

-Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) is required

-Strong interpersonal skills

-Conflict management and resolution skills

-Strong written and verbal communication skills

LANGUAGE SKILLS 

Ability to read, analyze, and interpret professional journals, governmental regulations, or legal documentation.  Ability to write reports and business correspondence to a prescribed format and style.  Ability to effectively present information and respond to questions from groups of children, top managers, clients and families, volunteers, and the general public.

MATHEMATICAL SKILLS 

Must have superb analytical skills. Ability to work with mathematical concepts such as probability and statistical inference.  Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

REASONING ABILITY 

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

CERTIFICATES, LICENSES, REGISTRATIONS

Valid NC or SC Driver's license.

PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms; stoop, kneel, crouch, or crawl; and talk or hear.  The employee frequently is required to climb or balance.  The employee is occasionally required to taste or smell.  The employee must frequently move up to 100 pounds.  Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

WORK ENVIRONMENT  

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually low.