Case Management Supervisor

Opportunity

The Care Management Supervisor Supervises the case management team and the care coordination of behavioral health members to promote quality and efficacy of care management delivery related to mental and behavioral health needs. Supervises day-to-day escalations and care management issues related to members or providers?

Additionally, the Case Management Supervisor will assist with the provision of or reinforcement of training principles for other team members. Key success factors for this role include acting as a SME in teamwork and team building, assisting and encouraging the team’s productivity, unity and flexibility. Job functions are performed in accordance with requirements of the QUEST Integration contract and health plan goals and quality outcome metrics.

• Monitor and review care management required documentation to maintain compliance with federal and state regulations and contractual agreements.
• Assign caseloads to care management staff based on state requirements, care management staff experience, and member needs.
• Works with senior management on escalated and complex care cases related to BH and provides guidance to junior team members to address member concerns.
• Educates and provides resources for care management team on key initiatives and member outreach.
• Evaluates care management team performance and provides feedback regarding performance, goals, and career milestones
• Provide coaching and guidance to care management team and providers to ensure members are receiving high quality care and information regarding service / care plan options, procedures, referrals, and healthcare benefits.
• Upon notification of a crisis the CM, and CM supervisor, as necessary, shall triage and employ necessary interventions to assist member recover from the crisis. If imminent danger is suspected or present activates emergency services, as necessary and consistent with training and policy.
• Monitors and review reports on a regular basis ensuring quality and productivity metrics are met and for case assignments and may perform audits of staff on a regular basis.
• Assists with onboarding, hiring, and training care management team members.
• Participates in workflow design/redesign and provides recommendation for improvements.
• Assists in reinforcing training principles.
• Gives constructive feedback to their direct reports to improve efficacy, efficiency and effectiveness of interventions and workload management.
• Provides professional, open and honest communication, courtesy and respect between supervisor/manager, and members of their team.
• Provides candid peer-review feedback to leadership team or others as requested to support performance reviews, identifying and offering suggestions on opportunities for improvement
• Identifies concerns and discusses actions with staff and managers to ensure issues are addressed
• Ability to resolve conflict with courtesy and respect
• Maintains accurate written documentation and records of case management activities in computer systems according to appropriate service coordination and/or clinical guidelines.
• Ensures compliance with all state and federal regulations, including HIPAA standards of confidentiality of protected health information, reporting critical incidents and reporting of quality-of-care issues.
• Adhere to regulatory compliance and quality guidelines as well as Aloha Care policies and procedures.
• Responsible for maintaining Aloha Care’s confidential information in accordance with Aloha Care policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to Aloha Care data based on the data classification assigned to this job title.

• Associate’s degree in Health Care Administration, Nursing, Long Term Services and Supports, Public Health, or related field related field or equivalent combination of education and experience.
• Minimum of 4 years of experience in related field.
• Minimum of 1 year of experience leading/managing and developing a team.
• Licensed RN with BH experience, LPN, LCSW, LSW, LMHC, LMFT or CSAC in the State of Hawaii
• Health plan experience with case management…