Competitive Compensation & Benefits Package!
Position eligible for –
- Annual incentive bonus plan
- Medical, dental, and vision insurance with low deductible/low cost health plan
- Generous vacation and sick time accrual
- 12 paid holidays
- State Retirement (pension plan)
- 401(k) Plan with employer match
- Company paid life and disability insurance
- Wellness Programs
See attachment for additional details.
Location: Remote option; Available for Burke and Catawba Counties.
Projected Hiring Range: Depending on Experience
Closing Date: Open Until Filled
Primary Purpose of Position: The Innovations Care Management Supervisor manages and supervises a team of Innovations Care Management team members to ensure coverage for each area assigned to the team. This position is responsible for management duties related to Innovations Care Management to ensure comprehensive assessment, care management and monitoring to individuals having a primary I/DD need, which may include a secondary physical health or behavioral health need. Travel is an essential function of this position.
Role and Responsibilities:
Responsibilities of the Innovations Care Management Supervisor include, but are not limited to, the following:
Quality Care Planning and Comprehensive Care Management Support:
- Ensure that all Individual Support Plans (ISPs) are complete, review them for quality control, and provide guidance to care managers on how to meet members’ needs.
- Provide enhanced support and assistance for complex clinical situations (e.g., complex placement or discharge planning, etc.) and complex planning scenarios (e.g., requests for home modifications, durable medical equipment, initiation of self direction, etc)
- Ensure that Care Managers proactively utilize available resources to minimize risk of crisis events and improve member health/outcomes (e.g., accessing clinical consultants to provide subject matter expert advice to the care team, utilizing resources available through NC START, initiating high risk/complex case staffings, etc.)
- Promote access and use of assistive technologies to support individuals with I/DD and TBI
- Ensure that team members have a strong understanding of home and community-based setting requirements and actively monitor for and promote same
- Promote use of person-centered tools to support active discovery and quality planning
- Provide coverage for vacation and sick leave (Supervisors cannot have a caseload but will provide coverage for vacation and sick leave)
- Assist Care Manager, as needed, in collaboration with providers, hospitals, physicians and other care team members to develop and implement quality plans and coordinate activities
- Promote problem-solving and goal-oriented partnership with individuals/legally responsible persons, providers, etc.
- Support timely and accurate submission of Service Authorization Requests (SARs), with remediation of any identified issues
- Ensure understanding and use of NCCARE360 by Care Managers
Supervision / Performance and Project Management:
- Proactively monitor performance of team members, providing appropriate and timely support and corrective action for any team member with below acceptable performance
- Provide and document supervision/coaching in adherence with Supervision/Coaching Protocol
- Objectively assess quality of case record documentation, achieving inter-rater reliability score of ≥85% on comprehensive record review
- Monitor contact frequency and contact types, ensuring that team members meet contact requirements per acuity tier or Innovations Waiver (whichever is higher) and that in-person contacts are a high priority
- Ensure expeditious follow-up on identified Medicaid eligibility issues, inclusive of issues impacting capitation payments
- Ensure that coordination of Medicaid Deductibles is consistent and that any issue/concerns are addressed in timely manner
- Assess and address training needs of team members
- Ensure timely and effective communication between Care Manager and Care Management Extenders, with Care Manager maintaining lead role and providing direction/guidance to Care Management Extender specific to member
- Ensure that members are accurately identified as members of special or priority populations (e.g., LTSS, TBI, EOR, etc) and that such designations are updated as applicable
- Ensure that assigned projects (e.g., National Core Indicators, Budget Corrections, MIE Survey Follow-Up, annual performance reviews, etc) are completed by established due dates for self and team members
- Closely monitor waiver slot implementation and termination activities, communicating status and identified barriers as indicated.
Other:
- Ensure that all concerns or grievances are reported and addressed
- Ensure that critical incidents and quality of care concerns are appropriately reported (e.g. reports to internal departments, DSS, DSHR, etc.)
- Support member’s right to choose Tailored Care Management entity, to request change in TCM entity or Care Manager
Knowledge, Skills and Abilities:
- Comprehensive knowledge of the assessment and treatment of I/DD and TBI needs, with or without co-occurring physical health or behavioral health needs
- Considerable knowledge of the MH/SU/IDD/TBI service array provided through Tailored Plan or Medicaid Direct contracts
- Understanding various I/DD and TBI diagnoses and their impact on the individual’s functional abilities, physical health and behavioral health (i.e., co-occurring mental health or SUD diagnosis), as well as their impact on the individual’s family/caregivers
- Understanding of home and community-based standards and service setting requirements
- Understanding HCBS, related planning, and 1915(c) services and requirements
- Knowledgeable about resources, supports, services and opportunities required for safe community living for populations receiving in-reach and transition services, including LTSS, BH, therapeutic, and physical health services.
- Working knowledge of laws, regulations, and program practices/requirements impacting members and families
- Exceptional leadership and interpersonal skills; highly effective communication ability
- 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
- Ability to learn and understand legal, waiver and program practices/requirements and apply this knowledge in problem-solving and responding to questions/inquiries
Education/Experience Required:
Bachelor’s degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services area or licensure as an RN; and five (5) years of experience providing care management, case management, or care coordination to complex individuals with I/DD or TBI;
OR
A Master’s degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services area; and three (3) years of experience providing care management, case management, or care coordination to complex individuals with I/DD or TBI;
AND
Must reside in North Carolina (or within 40 miles of the NC border)
Must have ability to travel regularly as needed to perform job duties
Education/Experience Preferred:
Minimum of 2 years prior supervisory experience highly preferred
Experience working with individuals with co-occurring physical health and/or behavioral health needs preferred.
Minimum of two years of prior long-term support services and/or Home and Community Based Services coordination experience preferred.
Licensure/Certification Requirements:
If a Registered Nurse (RN), must be licensed in North Carolina.
