TCM Care Manager Supervisor

Job Description

Job Description

Description:

Position: Care Manager Supervisor

Department: Tailored Care Management

Location: Hybrid Remote in the Trillium Catchment Area

Reports To: Tailored Care Management Director

Scope of Work Summary: The Tailored Care Management Care Manager Supervisor oversees no more than eight Care Managers Within the framework of Tailored Care Management (TCM), beneficiaries of the Behavioral Health I/DD Tailored Plan are assigned a dedicated care manager who, together with a multidisciplinary team, offers comprehensive care management. This holistic approach addresses a multitude of needs, including physical and behavioral health, I/DD, traumatic brain injury (TBI), pharmacy services, long-term care and support (LTSS), and any unmet health-related resources. The Care Manager Supervisor (CMS) will not carry a caseload but will step in during periods of vacations, sick leaves, or staff turnovers, guaranteeing seamless service delivery. This role includes the crucial task of examining all Tailored Management care plans and Individual Support Plans. The Supervisor also provides necessary guidance to care managers in meeting member needs.

Expectations:

Staff Development

Ensure staff comply with organizational and departmental policies, procedures, and workflows.

Oversee up to eight care managers.

Equip care managers with the necessary tools and resources to achieve organizational goals and maintain compliance with licensure, regulatory, and accreditation requirements.

Foster a positive, diverse, inclusive, and respectful working environment.

Provide ongoing coaching, mentoring, and ensure staff's professional development.

Monitor training compliance of care managers and complete all required agency pieces of training.

Policy and Compliance

Maintain transparent and ethical standards that are consistently applied across all staff members.

Ensure care management interventions and documentation meet state/Medicaid/Agency requirements.

Ensure adherence to agency and departmental policies and procedures to comply with agency, state, and federal regulations.

Develop policies and procedures pertaining to the implementation and sustainability of care management services.

Demonstrate awareness and compliance with all agency policies and procedures, as well as state and federal statutes and regulations related to care management.

Quality Control and Care Management

Establish performance goals and deadlines that align with the organization's vision.

Monitor the response of care managers and their adherence to agency-set standards.

Offer clinical oversight by identifying when escalations are necessary or when referrals are needed.

Regularly review and analyze trends to spot opportunities for service utilization and implementation enhancements.

Conduct case record reviews to ensure the provision of quality services.

Guarantee care management activities cater to the needs of special health care populations.

Advocate for and facilitate person-centered and whole-person care management, following all applicable waiver requirements.

Manage the appropriate distribution of member assignments to the care management program.

Maintain required certifications or licensures for the role.

Participate in the agency's 24-hour coverage schedule, offering services, consultation, or referral as needed during emergencies.

Step in for care managers as needed to ensure all members' needs are satisfactorily met.

Hold regular meetings with care management staff to monitor contact numbers, assessments, and care plan implementations, ensuring both compliance and quality of services provided.

Travel to community locations, other agencies, and outreach destinations as necessary to meet members' needs.

Visiting members at their living arrangements, such as their own home, a relative's home, a care facility, or any other location, is essential and required to ensure the delivery of high-quality care.

Complete all required trainings as defined by service rules, accrediting bodies, the agency, etc.

Participate actively in management and clinical team meetings as required.

Ensure strict compliance of staff with all organizational policies and procedures.

Fulfill any other relevant responsibilities as assigned by the supervisor.

Community Engagement and Service Coordination

Participate in local, regional, and state meetings as required.

Partner with community stakeholders to assess opportunities, barriers, and coordinate service delivery system.

Maintain relationships with providers, community agencies, professionals, and other stakeholders.

Collaborate with other departments/supervisors to meet consumer and agency goals.

Analyze and monitor community capacity for service needs, service gaps, and the implementation of evidence-based/best practices.

HealthKeeperz Leadership Expectations:

As a HealthKeeperz leader, the Care Manager Supervisor is expected to embody the principles of the HealthKeeperz Barnabas Culture of Encouragement. This entails fostering a supportive and inclusive work environment, promoting teamwork, and upholding the core values of the organization, including compassion, excellence, ownership, and putting family first. By leading by example, the Care Manager Supervisor will demonstrate a commitment to the mission of HealthKeeperz: caring for all people for the glory of God.

By embracing these responsibilities and aligning their leadership style with the HealthKeeperz mission, vision, values, and culture, the HealthKeeperz Tailored Care Management Care Manager Supervisor will contribute to the organization's ongoing success and impact in providing high-quality care to individuals in need, the staff they support, and stakeholders we partner with.

Results

The Tailored Care Management Care Manager Supervisor’s work is expected to produce the following results in the four key pillars of the HealthKeeperz vision statement.

Culture

All individuals touched by HealthKeeperz will be afforded every opportunity to flourish that we can provide.

TCM Care Managers and Extenders will feel invested in, and cared for, as individuals and contributors to the TCM team.

TCM team members will have the opportunity to be part of a fantastic team where they experience life-giving work, partner with outstanding talent, enjoy uplifting growth, receive rewarding compensation, be guided by inspirational leadership, contribute to sustainable strategies, and share in healthy communication.

Innovation

Encouragement for employees to think creatively, take calculated risks, and generate new ideas.

Internal and external collaboration will be encouraged.

Smart investments in technology and infrastructure that drive innovation.

Under the leadership of and in collaboration with the Director of Tailored Care Management at HealthKeeperz, the Care Manager Supervisor is instrumental in driving innovation within our organization. Together, they spearhead the implementation of an innovative system of care. The CMS plays a vital role in ensuring that HealthKeeperz delivers the highest level of care to our beneficiaries and achieves improved outcomes.

Excellence

Fostering a culture of compliance and excellence that sets clear expectations.

Achieving compliance and excellence in regulatory compliance, quality metrics, and safety outcomes.

Enhancing patient outcomes through continuous improvement and innovative approaches.

Financial Health

Meets revenue, margin, and collection goals.

Creates an opportunity for HealthKeeperz to engage in the ministry of financial stewardship.

Skills:

The Case Manager Supervisor of the Tailored Care Management program leads a comprehensive, person-centered approach to care coordination. The following skills reflect the specific expertise and qualifications required for the Director of a Tailored Care Management program.

Service Understanding and Compliance Knowledge

Proficient understanding of Person-Centered Thinking and planning.

Knowledge of various benefit plans, including Medicaid basic, enhanced MHSUD, and waiver benefits.

Understanding of the NC Division of Mental Health, Developmental Disabilities, and Substance Abuse IPRS Target Populations and Service Array.

Familiarity with 1915(b) and NC Innovations Waiver.

Knowledge of Medicaid and Innovations Service Array.

Understanding of applicable federal laws, including Substance Abuse and HIPAA Privacy Laws.

Assessment and Planning Skills

Skilled in the use of Motivational Interviewing.

Knowledge of LOC process, SIS for IDD, and FASN assessment for TBI.

Proficient in using assessments to develop plans of care.

Demonstrated knowledge of the assessment and treatment of developmental disabilities, with or without co-occurring mental illness.

Expertise in ISP development training.

Technical and Decision-Making Skills

Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.).

Ability to make prompt, independent decisions based on relevant facts.

Communication and Interpersonal Skills

Strong interpersonal skills.

Skilled in conflict management and resolution.

Proficient in written and verbal communication.

Education/Certifications:

Licensed, provisionally licensed, certified, registered, or permitted by the governing board regulating a human service profession (including LCSW/LCSWA, LCMHC/LCMHCA, LMFT/LMFTA, LCAS/LCASA, LPA) or licensed as a Registered Nurse (RN); and three years of experience providing care management, case management, or care coordination to the population being served.

Physical Demands:

The above statements describe the general nature and level of work being performed by individuals assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required for the position. This position also requires standing, sitting, walking, lifting, and other physical activities for extended periods, including driving. All employees may have other duties assigned at any time.