The Physical Health Consultant Supervisor provides oversight to our Care Management Consultants, who support our transition care teams by providing physical health related consultation for members primarily in Acute Care facilities. The Care Management Consultants may serve as the secondary case manager for our Internal Transition of Care Team when there is a need to support members with complex physical health needs.
This position will allow the successful candidate the ability to work remote 4 days of the week. This position will require travel within the communities Alliance serves.
Responsibilities & Duties
Supervise and Develop 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
Supervisor Unit Operations
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 team specific goals and objectives ensuring alignment with system strategy, vision, mission, and values
Participate in formulating, implementing, and evaluating strategies for specialized staff education as it relates to member care, case management and plans of care regarding physical health
Ensure Physical Health Team is integrated into and supporting the transition care team for members with physical health needs in Acute Care facilities and other settings as needed
Provide Customer Service
Develop strong working relationships with providers and internal/external stakeholders by scheduling ongoing opportunities to share feedback and collaborate
Exercise conflict resolution skills to appropriately resolve issues with providers and internal/external stakeholders
Develop strong working relationships among the department and provide customer services with providers and stakeholders internal/external by scheduling ongoing opportunities to share feedback and collaborate
Quality/Data/Analytics
Review, validate and interpret risk stratification data and population health groups and recommends 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
Compliance with Alliance Policy and Procedure
Ensure adherence to all Alliance Organizational Policies and Procedures and Care Management Desk Procedures
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 throughout the organization
Minimum Requirements
Education & Experience
Graduation from an accredited school of nursing and five (5) years of experience with direct patient care, and two (2) years of applicable experience providing care management, case management, or care coordination to members with Physical Health conditions. Must be licensed as a Registered Nurse in North Carolina.
Or
Master’s degree in Occupational and/or Physical Therapy from an accredited college or university and three (3) years post graduate degree experience with direct patient care, and two (2) years of applicable experience providing care management, case management, or care coordination to members with Physical Health conditions. Must be licensed as an Occupational Therapist or Physical Therapist in North Carolina.
Or
Master’s degree in Human Services from an accredited college or university and three (3) years post degree experience providing care management, case management, or care coordination to members with Physical Health conditions. Must be fully Licensed LCSW, LMFT, LCAS, LCMHC, or LPA in North Carolina
Preferred: Two (2) years supervisory experience and ACM or CCM Certification 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 1915(b) and NC Innovations Waiver
Knowledge of Medicaid and Innovations Service Array
Knowledge of applicable Federal laws, including Substance Abuse and HIPAA Privacy Laws.
Knowledge of National Accreditation standards and regulations
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
Ability to communicate effective orally and written
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
$75,600.00 to $96,390/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
