Special Populations Manager; Primarily Remote, North Carolina

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.

• 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

• 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…