Health Management Program Manager (Care Transitions Team)

Role and Responsibilities: 

Clinical/Operational Leadership 

• Manages and oversees the Care Transitions Team with a positive approach.
• Oversees internal committees and completes reports related to the Care Transitions Program (Adult or Child/Adolescent). 
• Collaborates with finance and contracts, utilization management, and network management to oversee adherence to non-UCR service allocations. 
• Participates in state and internal meetings about Care Transition services and notifies applicable Clinical Director of new and/or changes in current regulations and guidelines regarding Care Transitions protocols in need of updating. 
• Collaborates with Utilization Management, Network Management, and Quality Management to:
  • Identify service gaps and needs
  • Ensure provider network has sufficient capacity to serve all identified needs of Care Management consumers, and 
  • Service delivery is in accordance with best practice models and clinical coverage policies.
• Collaborates with housing staff to ensure sufficient housing capacity that meets identified needs of consumers.
• Provides leadership, in collaboration with other managers, to promote strong cohesiveness among all company employees regardless of department, role or office location…promotes one vision, one voice
• Ensures visibility within region (e.g., attends regional state hospital meeting(s), CCNC meetings, service collaborative meetings, periodically attends team meetings facilitated by Supervisors if applicable, travels to office locations for supervision, etc.) to promote rapport and comfort level among all team members
• Collaborates with Clinical Director, Managers, and Supervisors, and others to promote customer/community stakeholder satisfaction through ongoing communication, refinement of delivery of care transitions services as needed.
• Ensures all activities are implemented according to the guidelines and regulations of the DMA Contract, DOJ Settlement, DMHDDSUAS, Mercer, URAC, and External Quality Review and established protocols/procedures.
• Monitors service implementation through monthly monitoring activities, supervision and monthly review of key performance data.
• Ensures implementation of an active performance improvement/quality assurance process, including Quality Improvement Projects, Strategic Plan, and Local Business Plan.
• Models and promotes person centered practices, including use of person centered language and person-centered tools in both management and clinical planning
• Monitors effectiveness of systems and guidelines through review of data and addresses identified issues/concerns.
• Ensures quality customer service is provided through all activities
• Completes all required reporting requirements, including reporting on performance indicators
• Participates in internal/external reviews and ensures follow-up is completed as needed
• Ensures active solution-focused collaboration with State Hospitals, Community Hospitals, Community providers and DSS to proactively identify to ensure needs of individuals meeting care management criteria are addressed
• Promotes a spirit of active collaboration with others both internally and externally, with focus on and positive outcomes for individuals supported
• Ensures timely resolution of all concerns, complaints and/or grievances

Clinical/Administrative Supervision

• Ensures recruitment, hiring and supervision of staff based on the needs of the unit.
• Ensures that all probationary and annual performance reviews are completed objectively and in a timely manner.
• Ensures regular observations, reviews of job performance and ongoing supervision to ensure appropriate provision of all activities.
• Provides training on job responsibilities for team members.
• Reviews and approves all employment paperwork for employees (e.g., timecards, employee reimbursement requests, etc.)
• Ensures appropriate documentation of meetings and clinical supervision
• Ensures all HR and related procedures are followed
• Ensures that all employees within team receive ongoing training of changes in state, agency or departmental regulations, policies, procedures, service definitions, and operations guidelines 

Knowledge, Skills and Abilities:

• Excellent organizational and management skills  
• Ability to coordinate, effectively train/coach and oversee the duties of others to ensure high quality services
• Working knowledge and expertise in the areas of mental illness, housing first, case management, and psychiatric rehabilitation
• Working knowledge of laws, regulations, and program practices/requirements impacting consumers
• Ability to exercise judgment and discretion in applying and interpreting policies and procedures.
• Ability to exemplify and promote in others a positive, solution-focused attitude
• Ability to promote effective partnerships between Partners BHM staff, providers, and community stakeholders
• Ability to understand and carry out complex oral and written instructions
• Ability to establish and maintain positive and effective working relationships with associates, officials and the public.
• Ability to work effectively with others to promote a team effort to address the needs of the individuals served.
• Ability to express directions, comments and opinions clearly and concisely in oral and/or written form.
• Excellent ability to understand and interpret complicated written material and verbal presentations.
• Diplomacy as well as the ability to handle stressful situations is essential.
• Excellent computer skills including proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.)
• Excellent problem solving, negotiation and conflict resolution skills.
• Propensity to make prompt, independent decisions based upon relevant facts and established processes.
• Detail oriented, able to independently organize multiple tasks and priorities, and to effectively complete reporting measures within assigned timeframes.

Education/Experience Required:  

• North Carolina Registered Nurse [RN], or 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), Fully Licensed Clinical Addiction Specialist (LCAS). 
• Three (3) years experience providing care management, case management, or care coordination to the population served.

Other requirements:  

• Must reside in North Carolina.
• Must have ability to travel as needed to perform the job duties.

Education/Experience Preferred:  

• Current medical/surgical and behavioral health experience preferred.  
• MH/IDD experience preferred. 
• 3 years health care supervisory experience, AND 3 years management experience preferred.

Licensure/Certification Required: North Carolina Registered Nurse [RN], Licensed Clinical Social Worker (LCSW), fully Licensed Clinical Mental Health Counselor (LCMHC), fully Licensed Psychological Associate (LPA), fully Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Addiction Specialist (LCAS).  Employee is responsible for complying with respective licensure board’s continuing education/training requirements in order to maintain an active license.