Supervisor-Complex Case Management (Full-time Remote, North Carolina Based)

The Supervisor for Complex Case Management will provide supervision, coaching, and monitoring of the Complex Case Management team, a team of licensed clinicians responsible for coordinating care for members identified for Complex Case Management.  The position will ensure that the Complex Case Management team performs work that aligns with Alliance’s CCM program description and NCQA guidelines.

This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office may be required.

Responsibilities & Duties

Supervision and Development of Staff

• 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
• 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

Supervise Team/Unit Operations 

• Participate in the initiation, development, and maintenance of clinical protocols and other population-based programs, facilitating collaboration and consensus of multidisciplinary teams
• Oversee the development of department specific goals and objectives ensuring alignment with NCQA and contractual requirements, system strategy, vision, mission, and values
• Formulate, implement, and evaluate strategies for specialized staff education as it relates to member care, complex case management and plan of care development
• Ensure members identified and/or referred to Complex Case Management are assigned timely to a Complex Case Manager

Data/Analytics 

• 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
• Utilize data to analyze needs of the members we serve, guide staff training development, identify resource needs and consistency of workflow implementation across disciplines

Compliance and Quality Monitoring 

• Ensure adherence to all Alliance Organizational Policies and Procedures and Care Management Desk Procedures
• Make recommendations to improve department procedures and increase operational efficiency
• Monitor trends and identify opportunities for enhancements in service utilization and implementation throughout the organization

Travel 

• 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

Minimum Requirements

Education & Experience

Required:

Master’s degree in Human Services or related field and three (3) years of experience providing complex care management, case management, or care coordination to the population being served. A license, provisional license, certificate, registration or permit issued by the governing board regulating a human service profession (examples include LCSW, LMFT, LCAS, LCMHC, LPA, RN) required.

Or 

Graduation from an accredited nursing school with Registered Nurse license and three (3) years of experience with at least two years of applicable experience providing complex care management, case management, or care coordination to the population served.

Leadership experience required.

Preferred:

Master’s Degree from accredited Program in Nursing and Three (3) years of full-time, post degree experience providing care management, case management, or care coordination to members with Behavioral Health and/or Physical Health conditions. 

Two (2) or more years leadership experience preferred.

Knowledge, Skills, & Abilities

• Demonstrated knowledge of the assessment and treatment of mental health, substance abuse, intellectual and developmental disabilities, 
• Knowledge of legal, waiver, accreditation standards and program practices/requirements. 
• Knowledge of the Alliance Health service benefit plans and network providers. 
• Person Centered Thinking/planning
• Detail oriented, 
• Ability to independently organize multiple tasks, priorities, and to effectively manage an assigned caseload under pressure of deadlines.
• Exceptional interpersonal skills, highly effective communication ability, 
• Ability to make prompt independent decisions based upon relevant facts and established processes.
• Problem solving, negotiation and conflict resolution skills 
• Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) is required.

Employment for this position is contingent upon a satisfactory background and MVR (Motor Vehicle Registration) check, which will be performed after acceptance of an offer of employment and prior to the employee's start date.

Salary Range

$77,868 - $99,282/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 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

 Want to learn more about what it's like work as part of the Care Management Team? Click on our video to learn more: https://youtu.be/1GZOBFx61QU 

Salary : $77,868 - $99,282