MHSU Care Management Manager

LOCATION: Alleghany County, NC, Ashe County, NC, Wilkes County, NC, Watauga County, NC, Avery County, NC, Alexander County, NC, and Caldwell County, NC / Remote

SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.

GENERAL STATEMENT OF JOB:

The Mental Health/Substance Use (MH/SU) Care Management Manager is responsible for providing oversight of the MH/SU Care Management team through providing proactive intervention and coordination of care to eligible members identified as Special Health Care Needs, Complex Care Management or High-Risk High Cost populations to ensure that these individuals receive appropriate assessment and services. The MH/SU Manager is responsible for determining eligibility for care management and assigning to and managing staff caseloads. This is a mobile position with work done in a variety of locations. The MH/SU Care Management Manager may work with staff, and members if necessary, in the communities. The MH/SU Care Management Manager is responsible for knowing and implementing organizational policies, Division and departmental specific guidelines.

Note: This position requires access to and use of confidential healthcare information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and Substance Abuse Patient Records law, 42 CFR Part 2, and various state laws. As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his/her capacity as an employee of Vaya Health. The individual filling this position shall also sign a confidentiality statement as an employee of Vaya Health.

ESSENTIAL JOB FUNCTIONS:

Management:

Will effectively implement organizational priorities, quality initiatives and programs through the MHSU CCM Team. Will provide administrative direction and clinical guidance to their team(s) regarding member care and community collaboration activities. Will be proficient in team workflows and use of technology used by MH/SU CCMs to complete routine work. Will represent the organization as well as their department/Division at designated community stakeholder, provider or DHHS related meetings. Will provide supervision to MH/SU Care Manager team by observing and monitoring paperwork/documentation to ensure that the following Care Management activities are carried out within the Vaya catchment area in an effective manner. Activities include but are not limited to employee coaching to ensure continuous improvement of performance in meeting the needs of the members and communities. Coaching includes both in person observation as well as review. Will conduct performance reviews as required and conduct employee trainings and job simulation exercises to include but not limited to policies and procedures and service definitions. Will work with employee to mediate dissatisfaction within the community.

Will ensure that MHSU Care Managers have knowledge of duties described below and carry out these duties within their respective teams by providing direct supervision. May provide direct CCM activities in situations that require such as staff shortages or an elevated need for services.

Ensures identification, assessment and appropriate Person Centered Care Planning for members identified as having Special Health Care Needs or as High Risk High Cost members (as supported by state funds) or other complex care management populations in order to link to determine appropriate formal and informal services and supports including a medical and behavioral health home and monitor services.

Clinical Assessment, Care Planning & Interdisciplinary Care Team:

Will ensure that MHSU Care Managers have knowledge of duties described below and carry out these duties by providing direct supervision, case review and reviewing operational reports. MHSU CM meet with members to conduct a comprehensive bio-psycho-social assessment in order to gather information on their overall health, including behavioral health, developmental, medical and social needs. The Health Risk Assessment (HRA) encompasses a comprehensive assessment addressing social determinants of health, mental health history and needs, physical health history and needs, intellectual/developmental disabilities, activities of daily living, access to resources, and other areas to ensure a whole person approach to care. MHSU Care Manager may administer the PHQ-9, GAD, CRAFT, ACES, LOCUS/ CALOCUS, and other assessments based on member's clinical needs. Scores are calculated and reviewed allowing MHSU CM to provide specific education and self- management strategies as well as linkage to appropriate therapeutic support(s). The assessment process includes reviewing and transcribing member's current medication and entering information into Vaya's Care Management platform to trigger the continuity of care process which results in the creation of a multisource medication list that is shared back with prescribers to promote integrated care.

MHSU CM Manager ensures the MHSU Care Manager uses the assessment to learn about the member's needs to assist the member and their team in planning for their care, prioritizing goals that to help them live the life they want in the community of their choice. MHSU Care Managers ensure members of the care team are involved in the assessment as indicated by the member and that other available clinical information is reviewed and incorporated into the assessment as necessary. Care Plans and CCM assessment are updated at a minimum of annually or when there is a significant life change for the member.

MHSU Care Management Managers ensures that care managers use the assessment to create a person-centered care plan for members to help define what is important to members for their health. Care Plans are created based on information collected in the assessment process. MHSU CM assist members in refining and formulating treatment goals, identifying interventions, measurements and barriers to the goals. MHSU CM works in an integrated care team including, but not limited to, an RN and pharmacist along with the member to address needs and goals in the most effective way. MHSU CM and member solicit input from the care team and monitor progress. MHSU Care Managers ensure Care Plans include specific services to address mental health, substance use or intellectual/developmental disability, medical and social needs as well as personal goals

MHSU Care Managers ensures that members/guardians have the opportunity to decide who they want at the care team meeting, coordinates, and may facilitate the team meeting where member Care Plan is discussed and reviewed. The MHSU Care Manager ensures that the assessment, care plan and other relevant information is provided to the care team as indicated in Vaya policy and necessary Care Plan elements are included in accordance with 2335.

Crisis planning with member and care team. MHSU Care Managers create a care management crisis plan which is a separate but complimentary to the behavioral health provider's crisis plan. MHSU CM collaborates with members to develop a Crisis Plan that is tailored to their needs and desires. The MHSU Care Manager ensures the crisis plan includes problem definition, physical/cognitive limitations, health risks/concerns, medication alerts, baseline functioning, signs/symptoms of crisis (triggers), de-escalation techniques. Provide crisis intervention, coordination, and care management if needed while with members in the community.

Essential job functions of the MHSU Care Management Managers include, but may not be limited to:

* CM Platform basics

* Outreach & Engagement

* Release of Information practices

* Health Risk Assessment

* Medication List and Continuity of Care process

* Care Planning

* Interdisciplinary Care Team and Ongoing Care Management

Collaboration:

Will ensure that MHSU Care Managers have knowledge of duties described below and carry out these duties by providing direct supervision. May provide services in situations that require such as staff shortages or an elevated need for services. Serves as a collaborative partner in identifying system barriers through work with community stakeholders. Manages and facilitates Child/Adult High-Risk Team meetings in collaboration with DSS, DJJ, CCNC, school systems, and other community stakeholders as appropriate. Works in partnership with other Vaya departments to address identified needs within the catchment. MHSU CM may participate in cross-functional clinical and non-clinical meetings and other projects to support the department and organization. Participate in routine multidisciplinary huddles including RN, Pharmacist, M.D. to present complex clinical case presentation and needs, providing support to other CCM's and receiving support and feedback regarding CCM interventions for clients' medical, behavioral health, intellectual /developmental disability, medication, and other needs.

MHSU CM participates in other high risk multidisciplinary complex case staffings as needed to include Vaya Medical Director, Utilization Management, Provider Network, and Complex Care Management leadership to address barriers, identify need for specialized services to meet client needs within or outside the current behavioral health system.

Supervisory Responsibilities:

This position supervises their respective teams by observing and monitoring paperwork/documentation to ensure that the Care Management activities are carried out within the Vaya catchment area in an effective manner. Will provide coaching to employees to ensure continuous improvement of performance in meeting the needs of the members and communities. Will conduct performance reviews as required and conduct employee trainings and job simulation exercises to include but not limited to policies and procedures and service definitions. Will work with employee to mediate dissatisfaction within the community.

Other duties as assigned.

QUALIFICATIONS & EDUCATION REQUIREMENTS:

A Master's degree in Human Service field (such as Psychology, Social Work, etc.) is required, along with at least two years of post-degree progressive experience providing similar services to the population served.

Additionally, valid licensure in profession (social work, counseling or psychology) is required.

PHYSICAL REQUIREMENTS:

Person in this position is required to have close visual acuity to perform activities that include viewing a computer terminal; and extensive reading. Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers. Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.

KNOWLEDGE, SKILL & ABILITIES:

Employee will participate in and maintain Care Management and Vaya trainings and proficiencies as required.

A high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance. This will require exceptional interpersonal skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts. Problem solving, negotiation, arbitration and conflict resolution skills are essential to balance the needs of both internal and external customers. Must be highly skilled at shifting between macro and micro level planning, maintaining both the big picture and seeing that the details are covered.

MH/SU CM Managers must exhibit an extensive understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) and have considerable knowledge of the MH/SU/DD service array provided through the network of Vaya providers. Additional knowledge in Vaya Medicaid B and C waivers and accreditation is essential.

The employee must be detail oriented, able to organize multiple tasks and priorities, and to effectively manage projects from start to finish. Work activities quickly change according to mandated changes and changing priorities within the department. The employee must be able to change the focus of his/her activities to meet changing priorities.

Training, learning and proficiency are tracked through the Care Management Training Matrix and any other required means. Training may be delivered in a variety of methods and forums. MHSU CM Manager must understand the following areas, in addition to other required trainings:

* BH I/DD Tailored Plan eligibility and services

* Whole-person health and unmet resource needs (ACEs, Trauma, cultural humility)

* Community integration (Independent living skills; transition and diversion, supportive housing, employment, etc)

* Components of Health Home Care Management (Health Home overview, working in a multidisciplinary care team, etc)

* Health promotion (Common physical comorbidities, self-management, use of IT, care planning, ongoing coordination)

* Other care management skills (Transitional care management, motivational interviewing, Person-centered needs assessment and care planning, etc)

* Serving members with I/DD or TBI (Understanding various I/DD and TBI diagnoses, HCBS, Accessing assistive technologies, etc)

* Serving children (Child- and family-centered teams, Understanding of the "System of Care" approach)

* Serving pregnant and postpartum women with SUD or with SUD history

* Serving members with LTSS needs (Coordinating with supported employment resources

MHSU CM Managers should be proficient in the aforementioned essential job functions. Job functions with higher consequences of error may be identified, and proficiency demonstrated and measured through job simulation exercises administered by the supervisor where a minimum threshold is required of the position.

In addition, MHSU CM Managers must have thorough knowledge of standard office practices, procedures, equipment and techniques and have intermediate to advanced proficiency in Microsoft office products (Word, Excel, Power Point, Outlook, Teams, etc)

LICENSURE:

Valid licensure or certification in profession (social work, counseling or psychology) is required. Acceptable licenses are Licensed Clinical Social Worker (LCSW), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Clinical Mental Health Counselor Supervisor (LCMHCS), Licensed Psychological Associate (LPA), or Licensed Marriage and Family Therapist (LMFT).

LOCATION REQUIREMENT:

In accordance with the BH and I/DD Tailored Plan requirements mandated by the NC Department of Health and Human Services, certain Vaya Health positions are required to be filled by individuals who reside in North Carolina, meaning someone who establishes a legal domicile in North Carolina and pays income tax in North Carolina, or resides within 40 miles of the North Carolina border. New hires from outside of North Carolina will have 60 days from the date of hire to meet this requirement, if applicable to the position.

This position is required to reside in North Carolina or within 40 miles of the North Carolina Boarder.

DEADLINE FOR APPLICATION: Open Until Filled

APPLY: Vaya Health accepts online applications in our Career Center, please visit http://www.vayahealth.com/careers-overview/ Ind.001