Alliance Health in
Special Populations Manager (Primarily Remote, North Carolina Based)
Alliance Health in, Morrisville, North Carolina, United States, 27560
Special Populations Manager (Primarily Remote, North Carolina Based) (Project Management)
The Manager of Special Populations is the primary subject matter expert (SME) and point of contact for Alliance's work to coordinate care and support and develop network providers to serve Special Populations, including children with complex needs (specifically children with co-occurring intellectual and developmental disabilities (IDD) and mental health (MH) support needs), children with special healthcare needs, transitional youth (age 18-26), and adults with dual diagnosis (IDD/MH).
This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Alliance Office for business and team meetings as needed.
Externally, this position will oversee state reporting requirements associated with the DRNC Settlement agreement for Complex Children, and support, educate, and liaise with providers, community stakeholders, and public and government entities (e.g., school systems, and the Departments of Social Services (DSS), Health and Human Services (DHHS), and Juvenile Justice (DJJ)).
Internally, the position will provide organization-wide support as SME on Special Populations, collaborating with the Care Management, Provider Networks, and Finance and other groups as needed.
Responsibilities & Duties Coordinate Care and Consult on Cases for Special Populations
Provide staffing consultations for Special Populations, particularly youth with complex and/or special health needs
Collaborate with Care Management resources and individuals/legally responsible persons in choosing service providers, ensuring objectivity in the process
Participate in proactive individual case consultations with Care Management and Medical team to provide multi-disciplinary review of members' needs
Assess initial function, interpersonal dynamic, and overall engagement between paid supports (direct service providers, QP, etc.) and the member
Facilitate referrals for services that fall under Early Periodic Screening Diagnosis and Treatment (EPSDT) as well as other supports including, but not limited to, NC START programs
Coordinate monitoring and technical assistance efforts within the Care Management department to inform and guide efforts of the team
Promote problem-solving and goal-oriented partnership with individuals/legally responsible persons, providers, etc.
Review available assessments, provide clinical recommendations to treatment team for implementation in the residential and outpatient settings
Document progress notes from interaction activities with the individual being served and their community treatment team
Assess and engage providers in potential needs for enhanced funding when found to be clinically necessary to provide support to a member(s) experiencing great challenges
Recognize and report critical incidents to supervisors and Quality Management
Report concerns to Quality Management as needed
Promote customer satisfaction through ongoing communication and timely follow-up on any concerns/issues
Seek clinical supervision from licensed practitioners and administrative supervision from the IDD/TBI Clinical Director as needed
Participate in case consultations concerning members with complex needs and DSS and DJJ involvement as needed
Provide system navigation and education for DSS social workers to understand the definition of complex needs and resources available to this population
Review clinical assessments to ensure all areas of the member's needs are addressed and understood by the treatment team
Consult with Providers and Provide Assistance via Workforce Development Program
Assess training needs of providers that support members who are included in special populations supported by CM and develop plans for provider development and growth in collaboration with PN Development Specialist team members
Develop and deliver training plans for involved providers
Offer additional technical assistance to providers as needed
Partner with PN team to ensure continuity of services as well as predictive treatment and support experience for members
Work with the Director of Provider Network Strategy and Initiatives to complete discovery regarding gaps in services both within availability of providers as well as clinical needs that do not clearly link to an existing service within any Alliance benefit plan
Identify providers to fill network gaps for Special Populations and link providers with their assigned provider support specialist
Facilitate planning with the New Service Implementation Team regarding developing new services and/or specialization of existing services
Report network disparities to CM leadership
Proactively respond to an individual's planned movement outside the Alliance catchment area to ensure a smooth transition without lapse in care
Proactively document support interventions to ensure that cross-departmental communication is timely and accurate
Provide technical assistance to providers (full breadth of Alliance-funded services) supporting members
Analyze Data and Prepare Reports for Leadership and Stakeholders
Provide updates to leadership regarding effectiveness and improvement opportunities for current service delivery for members with DSS, DJJ, and/or other multi-system involvement
Collect required data and lead analysis efforts related to the Children with Complex Needs settlement class
Identify and respond to gaps in addressing assessed trends in children's clinical needs to include geographical proximity, capacity to provide evidenced based practices, and utilization rates
Monitor and respond to Crisis and Transitional provider admissions vacancy rates, and denial reasons
Staff concerns about psychotropic medication utilization for special populations, such as polypharmacy, with PH team (including with UM and CM)
Prioritize Children with Complex Needs Steering Committee data-informed strategies
Recommend a plan for how Alliance will address future state requirements that come about as a result of the Complex Children's Settlement agreement or related agreements/settlements
Serve as Alliance point of contact for the DRNC Children with Complex Needs Settlement Agreement
Additional Organizational Support
Offer guidance, resources, and preparation for professional certifications for staff with limited IDD experience
Serve as a member of the Medical team to address assessment of needs, planning, and monitoring of services rendered and provide consultation, education, communication, and system navigation to the Care Management team members supporting children and adults with complex needs
Route provider claims issues to Alliance Finance team members who can appropriately respond
Education & Experience Required:
Master's degree in a Human Services field from an accredited college or university and five (5) years progressive post‑degree experience in the field of Mental Health or Intellectual/Developmental Disabilities
Doctoral or other terminal degree in Human Services from an accredited college or university with three (3) years post‑graduate experience in the field of Mental Health or Intellectual/Developmental Disabilities
Preferred:
Experience working with a variety of systems (e.g., DSS, DJJ, family systems, provider systems, etc.)
Experience with planning for and coordination of both IDD and MH enhanced services
Full or Associate level clinical license (LCSW, LCMHC, LMF, or LPA) is preferred
Other behavioral health related certifications preferred including NADD and/or NACCM certification
Knowledge, Skills, & Abilities
Demonstrated knowledge of the assessment and treatment of intellectual and developmental disabilities, with co-occurring mental health conditions
Knowledge and experience collaborating with county departments of social services, department of juvenile justice, crisis response and community‑based treatment providers including training highly preferred
Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.)
Exceptional interpersonal skills
Highly effective communication skills
Problem solving, negotiation, and conflict resolution skills
Ability to learn and understand legal, Medicaid Waiver, and accreditation standards and program practices/requirements and, toapply this knowledge in problem‑solving and responding to questions/inquiries
Ability to make prompt independent decisions based upon relevant facts and established processes
Ability to independently organize multiple tasks and priorities, and to effectively manage an assigned caseload under pressure of deadlines
Salary Range $101,764-129,749/Annually
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.
Benefits
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
Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
See job description
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This position will allow the successful candidate to work a schedule that will be primarily remote. While there is no expectation of being in the office routinely, they will be required to come into the Alliance Office for business and team meetings as needed.
Externally, this position will oversee state reporting requirements associated with the DRNC Settlement agreement for Complex Children, and support, educate, and liaise with providers, community stakeholders, and public and government entities (e.g., school systems, and the Departments of Social Services (DSS), Health and Human Services (DHHS), and Juvenile Justice (DJJ)).
Internally, the position will provide organization-wide support as SME on Special Populations, collaborating with the Care Management, Provider Networks, and Finance and other groups as needed.
Responsibilities & Duties Coordinate Care and Consult on Cases for Special Populations
Provide staffing consultations for Special Populations, particularly youth with complex and/or special health needs
Collaborate with Care Management resources and individuals/legally responsible persons in choosing service providers, ensuring objectivity in the process
Participate in proactive individual case consultations with Care Management and Medical team to provide multi-disciplinary review of members' needs
Assess initial function, interpersonal dynamic, and overall engagement between paid supports (direct service providers, QP, etc.) and the member
Facilitate referrals for services that fall under Early Periodic Screening Diagnosis and Treatment (EPSDT) as well as other supports including, but not limited to, NC START programs
Coordinate monitoring and technical assistance efforts within the Care Management department to inform and guide efforts of the team
Promote problem-solving and goal-oriented partnership with individuals/legally responsible persons, providers, etc.
Review available assessments, provide clinical recommendations to treatment team for implementation in the residential and outpatient settings
Document progress notes from interaction activities with the individual being served and their community treatment team
Assess and engage providers in potential needs for enhanced funding when found to be clinically necessary to provide support to a member(s) experiencing great challenges
Recognize and report critical incidents to supervisors and Quality Management
Report concerns to Quality Management as needed
Promote customer satisfaction through ongoing communication and timely follow-up on any concerns/issues
Seek clinical supervision from licensed practitioners and administrative supervision from the IDD/TBI Clinical Director as needed
Participate in case consultations concerning members with complex needs and DSS and DJJ involvement as needed
Provide system navigation and education for DSS social workers to understand the definition of complex needs and resources available to this population
Review clinical assessments to ensure all areas of the member's needs are addressed and understood by the treatment team
Consult with Providers and Provide Assistance via Workforce Development Program
Assess training needs of providers that support members who are included in special populations supported by CM and develop plans for provider development and growth in collaboration with PN Development Specialist team members
Develop and deliver training plans for involved providers
Offer additional technical assistance to providers as needed
Partner with PN team to ensure continuity of services as well as predictive treatment and support experience for members
Work with the Director of Provider Network Strategy and Initiatives to complete discovery regarding gaps in services both within availability of providers as well as clinical needs that do not clearly link to an existing service within any Alliance benefit plan
Identify providers to fill network gaps for Special Populations and link providers with their assigned provider support specialist
Facilitate planning with the New Service Implementation Team regarding developing new services and/or specialization of existing services
Report network disparities to CM leadership
Proactively respond to an individual's planned movement outside the Alliance catchment area to ensure a smooth transition without lapse in care
Proactively document support interventions to ensure that cross-departmental communication is timely and accurate
Provide technical assistance to providers (full breadth of Alliance-funded services) supporting members
Analyze Data and Prepare Reports for Leadership and Stakeholders
Provide updates to leadership regarding effectiveness and improvement opportunities for current service delivery for members with DSS, DJJ, and/or other multi-system involvement
Collect required data and lead analysis efforts related to the Children with Complex Needs settlement class
Identify and respond to gaps in addressing assessed trends in children's clinical needs to include geographical proximity, capacity to provide evidenced based practices, and utilization rates
Monitor and respond to Crisis and Transitional provider admissions vacancy rates, and denial reasons
Staff concerns about psychotropic medication utilization for special populations, such as polypharmacy, with PH team (including with UM and CM)
Prioritize Children with Complex Needs Steering Committee data-informed strategies
Recommend a plan for how Alliance will address future state requirements that come about as a result of the Complex Children's Settlement agreement or related agreements/settlements
Serve as Alliance point of contact for the DRNC Children with Complex Needs Settlement Agreement
Additional Organizational Support
Offer guidance, resources, and preparation for professional certifications for staff with limited IDD experience
Serve as a member of the Medical team to address assessment of needs, planning, and monitoring of services rendered and provide consultation, education, communication, and system navigation to the Care Management team members supporting children and adults with complex needs
Route provider claims issues to Alliance Finance team members who can appropriately respond
Education & Experience Required:
Master's degree in a Human Services field from an accredited college or university and five (5) years progressive post‑degree experience in the field of Mental Health or Intellectual/Developmental Disabilities
Doctoral or other terminal degree in Human Services from an accredited college or university with three (3) years post‑graduate experience in the field of Mental Health or Intellectual/Developmental Disabilities
Preferred:
Experience working with a variety of systems (e.g., DSS, DJJ, family systems, provider systems, etc.)
Experience with planning for and coordination of both IDD and MH enhanced services
Full or Associate level clinical license (LCSW, LCMHC, LMF, or LPA) is preferred
Other behavioral health related certifications preferred including NADD and/or NACCM certification
Knowledge, Skills, & Abilities
Demonstrated knowledge of the assessment and treatment of intellectual and developmental disabilities, with co-occurring mental health conditions
Knowledge and experience collaborating with county departments of social services, department of juvenile justice, crisis response and community‑based treatment providers including training highly preferred
Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.)
Exceptional interpersonal skills
Highly effective communication skills
Problem solving, negotiation, and conflict resolution skills
Ability to learn and understand legal, Medicaid Waiver, and accreditation standards and program practices/requirements and, toapply this knowledge in problem‑solving and responding to questions/inquiries
Ability to make prompt independent decisions based upon relevant facts and established processes
Ability to independently organize multiple tasks and priorities, and to effectively manage an assigned caseload under pressure of deadlines
Salary Range $101,764-129,749/Annually
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.
Benefits
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
Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
See job description
#J-18808-Ljbffr