Director - Integrated Healthcare Management at Alliance Health in Morrisville, North Carolina

Job Description:

The Director of Integrated Healthcare Management is the program lead for a team of behavioral and physical health consultants within Care Coordination who will support members with complex physical health presentation. The Director will define physical health outcome targets for those served by Alliance Care Teams and collaborate with Provider Network directors to ensure that desired outcomes from the physical health consultants are consistent with those established for provider Care Management Agencies and Tier 3 Advanced Medical Homes. This position will collaborate with the Directors of Community Care Management and Care Management Support to ensure that a cohesive and well-coordinated approach to whole person care is achieved for the members served and for the staff working within the department.    

This position will allow the successful candidate to work a schedule which will include both onsite as well as remote work certain days of the week as approved by their supervisor.

Responsibilities and Duties

• Collaborates with Medical Management team on development and implementation of clinical decision making workflows. Analyzes population health trends and collaborates with Medical Management on interpretation and business action steps.


• Represents the Integrated Healthcare program in Network provider related performance discussions to ensure agreement of desired outcomes across care team, CMA and AMH care management models. This may include collaboration with hospitals and other behavioral health inpatient and/or physical inpatient units within the Alliance Health network.


• Develops workflows and collaborates across Alliance departments to understand data from a variety of sources as this relates to the physical health care risk and need for support of members served.


• Provides direct clinical and administrative supervision of team members. This may include routine clinical review of cases, interpretation of census data, advising team members regarding outreach to network providers regarding cases where care teams are engaged, development and monitoring of team performance plans and training and coaching as needed.


• Incorporates knowledge of Alliance health benefit plans and cross departmental structure to help guide efforts of care teams in supporting members with service engagement, assessing impact and seeking resolution of disparities regarding social determinants of health, monitoring census risk stratification for changes that will impact overall management of cases served.


• Develops educational materials for members regarding risks/benefits of physical health related services if needed in collaboration with community/network providers.


• Recommends continuing education opportunities for maintenance of clinical licensure and/or certifications of physical health care team members as well as recommending physical health trainings to Chief Medical Officer for use with non-licensed staff.


• Monitors program dashboard and responds to risks identified.


• Uses a population health management approach when developing policies, procedures and workflows which impact the work of the department.


• Provides administrative supervision of the Olmstead Program Manager to ensure that terms of Transitions to Community Living Initiative are successfully met and that activities of Olmstead Liaison team are managed.


• Leads consultation and outreach to community based physical health providers serving members with care team involvement.


• Provides oversight of the physical and behavioral health consultants review of ISPs for Innovations and TBI cases with exceptional medical support needs including supporting team consideration of DME and other equipment to assist with desired recovery and/or rehabilitation outcomes.


• Maintains effective interpersonal relations with Alliance staff, providers, partners and community stakeholders.


• Provides effective and timely response to phone calls, email and other communications and requests.


• Exhibits professionalism, enthusiasm, courtesy, adaptability, flexibility, and spirit of cooperation in the work environment.
  
   

Minimum Requirements

Graduation from a state accredited school of nursing and five (5) years of experience in psychiatric nursing and/or developmental disabilities. Must be licensed as a Registered Nurse in North Carolina. 

Master's degree in nursing and experience working with targeted populations including mental health, intellectual/developmental disabilities, substance use disorders, and traumatic brain injury preferred. 

 

Knowledge, Skills, and Abilities

• Clinical experience working with target Alliance populations anticipated for Tailored Plan implementation including a diverse scope of practice experience directly working with or administratively managing the care needs for individuals with intellectual/developmental disabilities, traumatic brain injury, mental health, and/or substance use disorders.


• Some practice experience or education specific to whole person care and population health approaches to care management.


• The employee must be detail oriented, able to independently organize multiple tasks and priorities, and effectively manage under pressure of deadlines.


• Problem solving and program analysis skills to assist in implementation and evaluation of programs and pilot projects.


• Computer literacy is required including familiarity with standard office software and ability to learn to utilize data analytics programs.


• Strong oral and written communication skills.


• Must demonstrate flexibility and adaptability as other related job duties occur.


• Exceptional interpersonal skills, ability to build and maintain positive relationships with internal and external customers and stakeholders.


• Employee must provide a positive image of Alliance at all times.
  
   

Salary

$75,438.27 to $129,865.03

Education

• Bachelors or better in Nursing

Licenses & Certifications

• Registered Nurse

See job description