Mgr-Transition of Care; Remote, North Carolina

The Manager-Transition of Care oversees a group of Transition Coordinator Supervisor I and II roles. As the leader of the supervisory team, the Manager-Transition of Care supports the Transition Coordinator Supervisors in ensuring that our Transition Coordinator/Physical Health teams are performing efficient and contract compliant Transitional Care Management in Acute Care Facilities, State Developmental Centers, and Jails.

This position is full-time remote. Selected candidate must reside in North Carolina and be willing to travel to the home office (Morrisville, NC) for onsite team meetings as needed.

• Work with Human Resources and Director of Transition of Care to maintain and retain a highly qualified and well-trained workforce
• Ensure staff are well trained in and comply with all organization and department policies, procedures, and business processes
• Organize workflows and ensure staff understand their roles and responsibilities for Tailored Plan Implementation
• Ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements
• Actively establish and promote a positive, diverse, and inclusive working environment that builds trust
• Ensure all staff are treated with respect and dignity
• Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members
• Work to resolve conflicts and disputes, ensuring that all participants are given a voice
• Set goals for performance and deadlines in line with organization goals and vision
• Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional development
• Cultivate and encourage efforts to expand cross-team collaboration and partnership

• Develop strong working relationships with departmental leadership of external stakeholders such as inpatient hospitals, emergency departments, crisis centers and Jail
• Develop strong working relationships within Provider Networks and Provider Network Evaluation to ensure capacity needs are met for members

• Review, validate and interpret risk stratification data and population health groups and recommend changes or adjustments to care management approach as needed
• Utilize data systems to monitor process improvement and resource utilization
• Knowledgeable of HEDIS measurements and population health within a complete care model
• Utilize evidence-based practice to ensure quality outcomes for members
• Implement recommendations to improve department procedures and increase operational efficiency
• Monitor trends and identify opportunities for enhancements in service utilization and implementation throughout Alliance

• Develop and support program operations in new Alliance regions, while adhering to Tailored Plan standards
• Participate in the initiation, development, and maintenance of clinical protocols and other population-based programs, facilitating collaboration and consensus of multidisciplinary teams as complete care is developed
• Oversee the development of department specific goals and objectives ensuring alignment with system strategy, vision, mission, and values
• Formulate, implement, and evaluate strategies for specialized staff education as it relates to member care, case management and plans of care

• Maintain medical record compliance/quality
• Ensure timely documentation of Care Coordination activities as required by department policy and procedures
• Ensure timely documentation of Warm Handoff Summaries and other communications to Provider Led Entities and other Health Plans
• Monitor completion of documentation in all systems to ensure data is entered timely and accurately
• Oversee the collection and delivery of data requests impacting program operations

• Adhere to all…