Health Home Care Management

Director

Essential Job Functions

Position Overview

SKIP of New York Inc. seeks a dynamic and experienced Director of Programs with knowledge and expertise in Health Home Care Management, Children and Family Services, Nursing, Early Intervention and/or Medicaid Waiver programs. The ideal candidate should possess strong leadership, effective communication skills, project management expertise and ability to facilitate positive organizational change and success. The Director is responsible for overall management of a large and growing department consisting of several supervisors, care managers, care navigators, quality assurance, training and other staff who provide care coordination and advocacy to several hundred high need children/youth who are medically involved or have developmental disabilities or varying chronic conditions, and their families, across NYS. The Director will perform a variety of duties relating to overall management and supervision of the Department to ensure compliance with regulatory mandates and provide services that support the overarching mission of SKIP, with the goal of enabling children to remain in their homes and communities. Importantly, the position requires a candidate who understands the strengths and challenges faced by the populations SKIP serves, subscribes to SKIP’s mission and values, and supports a culture that enhances and encourages professional development of staff, a positive and productive working atmosphere, with an eye to fiscal responsibility and a heart to guide others in achieving positive outcomes in the lives of families served. The responsibilities and essential job functions of this position are ever evolving and may change based on needs of the department and agency, so the individual who holds this role must be flexible and adept.

Qualifications

The Director position is a multipurpose position requiring a minimum five years of prior management and supervisory experience within health/human services, education, nursing, social work, or other systems supporting children and families with long term, chronic health and developmental conditions. Preference may be given to candidates with at least a Masters or Doctorate degree in a related field, with a minimum 7 years post graduate experience, including a minimum 4 years of supervisory/management experience. Familiarity with NYSDOH Health Home, Children’s Waiver and Early Intervention programs preferred, along with experience supporting medically fragile populations. The ideal candidate will have a demonstrated track record of success in leadership/supervisory positions, program operations, policy development, and demonstrated ability to work collaboratively and form strong and lasting professional relationships across varying provider networks and stakeholders. Excellent analytical, written and verbal skills, as well as positive and professional in-person and phone etiquette. Leadership, organization, time management and communication skills are essential to the position.

Reports to: Senior VP of Health Home Care Management

Position Type: Full-Time Exempt In-office

Hours: 37.5 weekly

Pay Range: $70,000.00 - $75,000.00

Position Responsibilities

Possible duties may include but are not limited to the following:

· Provide overall administration/management of Health Home Care Management program and services, inclusive of staff and clients served out of SKIP’s NYC office, with additional support across other regions as needed. Direct, coordinate, inspire, and guide provision of quality services to children and families.

· Promote leadership, accountability, collaboration, and positivity across the Care Management Team.

· Manage billing, budgets and revenue, shape policies, develop and implement strategic plans.

· Work as a collaborative partner with other Directors and Executive staff in establishing processes and procedures to ensure mandated regulations and best practices are understood and adhered to.

· Translate complex concepts, including regulatory policy, in ways that can be understood by all members of the organization and to ensure SKIP’s practices align with State, Federal and Health Home policy directives. Participate in process reengineering and improvement initiatives to identify opportunities for continued improvement, ensuring the Department continues to operate efficiently.

· Interact with internal and external contacts (e.g., vendors/service providers, State and government agencies, and various other stakeholders). Liaison with Health Homes, Waiver Programs/Providers, Managed Care Plans and NYS DOH, collaborating/coordinating with all ancillary staff and contacts.

· Manage Health Home and Children’s Waiver Enrollments, Level of Care (LOC) processes-outcomes, and client Transition activities. Improve outreach and intake practices and increase program enrollments.

· Provide technical assistance and establish training and curriculum of processes, procedures and best practices for staff.

· Monitor program outcomes, deliverables, quality improvement initiatives, compliance, and report on departmental performance. Interpret and manage data and outcomes for evaluative purposes.

· Report directly to Sr. VP of Health Homes, regularly report departmental status to Executive team where appropriate, and provide weekly direct supervision to Supervisors who are, in turn, responsible for managing Care Managers. Provide additional supervisory oversight to Quality Assurance, Care Manager, Care Navigator or other departmental staff as needed. Maintain ongoing physical presence and contact with staff in office, offering as needed 1:1 and team support, along with recurring supervisory meetings.

· Fill in for Supervisors and other Care Management staff as needed when staff are absent.

· Work closely with staff and families to ensure necessary services are delivered and SKIP’s mission promulgated. Participate in site visits, in-person meetings, conference calls, etc. as needed.

· Collaborate with other SKIP Directors and staff to meet Departmental and Organizational goals.

· Participate in development of grant proposals.

· Conduct comprehensive reviews of client records, both physical and electronic, reinforcing quality and comprehensive case reviews across Care Teams.

· Assist Care Managers and Supervisory staff with documentation transmittals and obtaining electronic signatures on program paperwork, through effective use of Adobe Sign.

· Conduct follow-up to obtain essential documentation from different governing bodies and collateral contacts. Assist with documentation uploads to electronic health records as needed.

· Ensure Health Home auditing protocols are adhered to and monthly-quarterly QA goals met, inclusive of introductory staff reviews, full chart audits, billing audits, audits of records in the process of closure and/or transition out of Health Homes, external State/OMIG audits, and preparing case files to be scanned. Respond to Health Home comprehensive, quarterly audits, and routine quality checks. Dispo Updates submitted as needed. Promote and lead quality assurance-improvement initiatives.

· Utilize internal tracking systems to monitor compliance of required eligibility, acuity and levels of care.

· Ensure staff address the needs of families served in a consistent, comprehensive and timely manner.

· Assist with and update shared lists of resources and provider contacts to be used by care manager staff.

· Assist with care manager retraining on program policies as needed, in collaboration with Staff Trainer.

· Review and process Child and Adolescent Needs and Strengths (CANS) assessments in UAS.

· Support care management staff to maintain neat and presentable physical & electronic case records for each person served, maintaining quality/audit-ready records.

· Assist supervisors in reviewing and finalizing plans of care/assessments and help as needed with general compliance follow-up.

· Support staff with submission of DSS-639/5144 disability determination requests to NYS.

· Manage and follow-up on Health Home/Managed Care Gaps in Care and Hospital/ER visit reporting, supporting the Care Management team in following Transitions of Care and Preventive Care policies. Ensure hospital alerts and GAPs in Care efforts are recorded in case notes, SKIP Tracker, and EHR.

· Hold regular 1:1 supervision meetings with any direct advisees, offering guidance and training, increasing frequency of supervision and support as necessary.

· Discuss trends in caseload and care management practices/issues. Establish time frames and set deadlines for team requirements to be completed as needed.

· Manage and facilitate caseload sizes, supervisory teams, case transfers and assist with client transitions.

· Assist with management of Incident Reporting processes. Help care management staff identify incidents, complete incident reports/memos, ensuring appropriate corrective actions and steps are taken to safeguard the health and safety of clients. Effectively utilize IRAMS Incident Reporting and Management System to report incidents to Lead Health Homes and DOH.

· Complete and assist with employee performance evaluations in a timely manner across the department. Mentor supervisors with respect to employee performance improvement initiatives, initiate and follow through with corrective action and with conflict resolution as needed.

· Lead monthly all-staff meetings, ensuring staff are appraised of new policies and program expectations.

· Provide ongoing support to care managers and supervisory staff, ensuring all billing and compliance standards are upheld across the department, completing family and core service contacts as needed.

· Review monthly billing for accuracy and ensure all relevant supporting documentation is in order and present in the record, to support billing. Effectively utilize SKIP, Health Home and State administrative reporting tools to complete validation reviews, identifying and addressing areas of concern.

· Lead the building of a comprehensive set of evidence and value based quality metrics and reporting tools to measure program success and to drive improvements in quality of care to families.

· Assist in development of job descriptions, review of applications, interviewing and onboarding new staff.

· Support staff in addressing insurance concerns (i.e. CIN Changes, moves, and inappropriate enrollments into managed care), reinforcing access to premium reimbursement opportunities for families.

· Ensure the Care Management team engages in monthly Health Home CMA meetings, EHR refreshers, and other State or agency-wide trainings and meetings as appropriate.

· Guide Care Management staff in effective support of families in accessing Nursing, Home Care, DME, Supplies, Home and Vehicle Accessibility, Transportation, Respite, Habilitation, Palliative Care, Therapies, parent/family support opportunities, grants and other services of relevance to the population.

· Assist the Health Home Care Management department with additional responsibilities in support of care management staff, completion of reports and/or other administrative tasks as assigned by Supervisor.

Additional Responsibilities

· Understand and follow all SKIP, NYS/DOH, Health Home program-related policies and procedures.

· Demonstrate strong written and verbal communication and organizational skills and policy analysis.

· Lead, guide and encourage SKIP’s NYC Health Home Team. Reinforce collaboration and team building, able to work well with and in support of others, including various other internal and external personnel.

· Maintain CANS-NY certification and satisfy ongoing training requirements. Oversee staff use of and adherence to Relias, Mindflash or other learning management systems and training expectations.

· Effectively utilize Health Commerce System, Uniform Assessment System (UAS), MAPP, ePaces, Tableau, NYEIS, EI-Hub, Health Home Care Management electronic health record systems including GSI, Sharepoint, using various other information technology as required, including SKIP Tracker. Review, manage, and utilize data across systems to guide positive improvements and updates to policy and work flow as needed.

· Ensure client confidentiality and privacy is maintained.

· Proficient in Microsoft Office Suite.

· Able to physically handle large case binders, travel in the community, use public transportation if needed, potentially meeting with clients in their homes or other locations where animals may be present.

· Review and approve timesheets/Paycom, expense reports and time off requests. Manage staff calendars and requests for use of remote work days.

· Actively participate in regular staff and supervision meetings, providing feedback and guidance.

· Be present, engaged, and assist with various other special projects and other duties as assigned.

Employee Acknowledgement

The job description is intended to provide an overview of the requirements of the position. As such, it is not necessarily all-inclusive, and the job may require other essential or non-essential functions, duties, or responsibilities not listed herein. Management, at its sole discretion, reserves the right to change, alter, and/or otherwise modify this job description at any time.

Regular, dependable attendance and punctuality are essential to this position and required.

Type: Full-Time in office

Hours: 37.5 Weekly

Pay Range: $70,000.00 - $75,000.00

Job Type: Full-time

Pay: $70,000.00 - $75,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to Relocate:

• New York, NY 10018: Relocate before starting work (Required)

Work Location: In person