Supervisor, Care Navigation

Care Navigation Supervisor

From the mountains to the coast, from large cities to small towns, Community Care of North Carolina is transforming health care. Informed by statewide data and predictive analytics, community-based care-managers work with local physicians and diverse teams of health professionals to develop whole-person plans of care that connect people to the right local resources and increase equity and access to high quality care.

To improve the health and quality of life for all North Carolinians by building supporting better community-based healthcare delivery systems.

Position Summary

Assist Director with development and implementation of the Care Navigation program including performance metrics, processes, and workflows. Drive distribution of work to ensure member engagement rates of the rising risk population and program outcomes are achieved. Collaborate between the care management, practice, quality improvement and/or provider relation teams as necessary to ensure seamless coordination of care for members. Ensure care navigation staff provide outstanding and efficient service to our members, including receiving and processing referrals from payers, practices, or members focused on Social Determinant of Health (SDOH), provide resources, screening for possible clinical needs, and referring to the clinical Care Management team as appropriate; driving members to primary care and other supports, addressing post discharge care needs, follow-up care, and preventive health services as needed.

The Supervisor, Care Navigation, will work remotely within regions to cover needs across the state.

Essential Functions

Operations

• Monitor and evaluate program measures, ensuring staff focus is placed on rising risk populations.
• Assist with developing and implementing new workflows, processes, and programs, as necessary to contribute to the program and the organization's success.
• Develop and implement a clear escalation pathway for cases that require a warm hand-off to a clinical team member.
• Supplement field-based, non-clinical care navigation, and member engagement activities as needed.
• Ensure quality and equal workload distribution to care navigation staff.
• Serve as a content expert for the team.
• Engage and maintain collaborative relationships with internal and external stakeholders.
• Arrange for Hospital/External Data System, Electronic Medical Record (EMR) system, or Health Information Exchange (HIE) system access, as necessary. Assure team members adhere to the policies, procedures and requirements of the external system supplying the Hospital/Data or EMR access.
• Utilize Hospital/Data, HIE or Electronic Medical Record system, as necessary.
• Assure team members have individual and/or team-based productivity goals to meet established performance targets that align with corporate goals and objectives.
• Adhere to CCNC Privacy and Security policies to ensure that patient and company data is properly safeguarded
• Other duties as assigned.

Quality Improvement

• Review staff documentation for adherence to quality standards and workflow processes
• Use data to drive decisions and plan/implement performance improvement strategies related to care navigation metrics and performance outcomes.
• Provide feedback to assigned team members on ways to improve the quality and effectiveness of service delivery.
• Complete quality performance audits
• Collaborate with leadership and team members to address member complaints and member survey results.

Staff Management

• Provide direct supervision of assigned care navigation staff.
• Participate in recruitment/interviewing/hiring.
• Ensure that new hires receive appropriate orientation and mentorship.
• Conduct performance evaluations.
• Maintain team accountability by empowering staff to work independently and as a team to meet company and program deadlines, objectives, and targets.
• Develop and monitor coaching and Performance Improvement Plans (PIP) with team members as needed.
• Provide ongoing staff development.
• Provide conflict resolution with staff.
• Ensure team members adherence to policies and procedures.
• Disseminate communication and facilitate team meetings.
• Approve time sheets, expense, mileage reimbursements, and other administrative duties as required.
• Coordinate coverage when team members are out.
• Maintain a cohesive, integrated, well informed, and educated team

Qualifications

Registered Nurse

• Graduation from an accredited school of nursing.
• BSN (Bachelor of Science in Nursing) preferred.
• Active, unrestricted RN (Registered Nurse) license to practice in North Carolina.
• Minimum two years' case/care management experience or relevant health care experience required.
• CCM (Certified Case Manager) certification required.
• Meets licensure or educational eligibility requirements as determined by The Commission for Case Management Certification
• Maintain ability to gain and keep access to Hospital/Data or Electronic Medical Record systems.
• Maintain a valid driver's license with current auto liability insurance.

Social Worker

• Social Worker (MSW required; LCSW (Licensed Clinical Social Worker) required)
• Minimum two years' case management experience or relevant health care experience required.
• CCM certification preferred; will obtain within 2 years of hire.
• Maintain ability to gain and keep access to Hospital/Data or Electronic Medical Record systems.
• Maintain a valid driver's license with current auto liability insurance

Knowledge, Skills, and Abilities

• Demonstrated understanding of value-based care principles, especially as they relate to Population Health management and improvement in health care quality.
• Advanced knowledge and understanding of office applications, including MS Office (Word, Excel, Power Point, Outlook) is required, as well as internet and digital literacy.
• Excellent communication skills oral and written.
• Critical thinking skills, effective clinical judgment, independent decision-making, change management skills, and problem-solving abilities.
• Skilled in establishing rapport with members, providers, and community partners either in person or via telephone.
• Strong organizational and time management skills
• Coaching, team building and supervisory skills.
• Ability to work independently and function as an integral part of the team.
• Motivational Interviewing skills and knowledge of adult learning and teaching principles
• Sensitivity to diversity of cultures, language barriers, health literacy, and educational levels
• Demonstrated knowledge of CCNC model of care management, population health, quality of care concepts, and health care delivery systems?and their relation to Population health
• Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives.
• Able to shift strategy or approach in response to the demands of a situation.
• Perform all other duties as requested.

Working Conditions

• "Hands-on" clinical treatment is NOT permitted when performing duties for the organization.
• Multiple contacts are required with various members, providers, multi-payer systems and community partners to ensure coordination of services; exposure to general office and household conditions, as well as communicable disease could occur.
• Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time.
• Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices.
• Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds.
• Travel using a personal vehicle may be required within the region and/or the State.

Why Join Us

• Make a meaningful impact on youth and families across North Carolina
• Work with a supportive and collaborative care team
• Competitive Benefits Package effective first day of employment
• Opportunities for growth, training, and bonus incentives*

Ready to improve the health and quality of life of all North Carolinians by building and supporting better community-based health care delivery systems?

• Apply today and join us in delivering compassionate care that makes a difference.

This is primarily a remote position. Occasional in-person training and travel may be required.