Supervisor, Care Management, RN (Hybrid Work Schedule)

Position Summary/Position

Under the direction of the Behavioral Health & Care Management (BH&CM) Managers, the Care Management Supervisor, RN is responsible for assisting in the management of clinical operations for IEHP Behavioral Health & Care Management Department. Responsible for overseeing daily operations of care coordination, continuity of care, UM authorization coordination process, complex care management and specialty services. Ensuring high quality coordination of care for all ambulatory behavioral health & care management processes as well as monitoring timely and accurate program processes. The RN Supervisor provides clinical support and guidance to RN, LVN, Social Worker, and non-clinical Team Members within the RN Scope of Practice.

Major Functions (Duties and Responsibilities)

1. Collaborate with the BH&CM Manager to coordinate daily staffing and coverage of the BH& CM units.
2. Supervise and train BH&CM assigned Team Members including monitoring of performance standards.
3. Develop introductory and annual evaluations with input from the BH& CM Manager.
4. Monitor and provide timely direction to the BH & CM assigned Team to ensure implementation of timely BH&CM processes. 
5. Provide leadership and supervision of day-to-day BH&CM functions to ensure high-quality, cost-effective services to Members, and compliance with regulatory requirements, including assisting with workload coverage when regulatory time frames may be in jeopardy.  This may include review and sign-off of screening and care plan contributions from non-licensed Team Members.
6. Monitors and provides timely direction to BH&CM assigned Team to ensure adherence to NCQA, CMS, DMHC and DHCS regulatory standards.
7. Monitors employees’ attendance, caseload ratios, performance, call volume, call abandonment rate, work productivity, etc.
8. Provides support and assistance to the Team when questions arise concerning covered services, contracted providers, and access to care.
9. Monitors the collaboration, facilitation, and care coordination of BH&CM Team with internal and external partners (i.e., County programs and services). 
10. Monitor’s telephone coverage daily, phone etiquette, and accuracy using company phone system.  Including constructive feedback and coaching for improvement opportunities.
11. Identifies operational and process improvement opportunities and facilitates a Team approach to develop efficiencies.
12. Assist in the development of internal Policy and Procedure Manuals and corresponding job aids.

Supervisory Responsibilities

Experience Qualifications

Three (3) or more years of experience in a managed care setting such as a Medical Group (IPA) or Health Plan. A minimum of one (1) year experience in a management role (i.e. Supervisor or Lead) is required. Minimum one (1) year clinical experience required.

Preferred Experience

Preferred Experience:  Current IEHP Team Members who have worked at last two (2) years in Behavioral Health & Care Management department may be considered for this position in lieu of the minimum one (1) year clinical experience requirement if they meet the following: 
- Successful job performance.
- Demonstrated ability to lead a project or group with successful outcome.
- Meets the knowledge/skills requirements below.

Education Qualifications

Associate’s degree from an accredited institution required.

Preferred Education

Bachelor’s degree from an accredited institution preferred.

Professional Certification

Certificate in Meeting Management (CMM) preferred.

Professional Licenses

Possession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN required.

Drivers License Required

Knowledge Requirement

Knowledge of regulatory standards of all BH&CM regulatory bodies (DHCS, DMHC, Medicare, NCQA) preferred. Working knowledge and understanding of behavioral health and care management principles and regulatory requirements for Medi-Cal and/or Medicare populations.  Understanding of and sensitivity to multi-cultural community.

Skills Requirement

Excellent written and verbal communication and interpersonal skills. Strong organizational skills, typing 45-50 wpm.  Analytical, time management, and problem-solving skills. Proficient with computer applications such as Microsoft Word, Excel, PowerPoint required.  Excellent communication, interpersonal and organizational skills. Strong writing skills, time management, and understanding with interpreting/analyzing data. Read and interpret data trends. 

Abilities Requirement

Ability to function with little to no supervision.  Self-starter and a team player.  Must have a high degree of patience. Values team building and including team members in process improvement.  Ability to verbalize, as well as demonstrate, a broad understanding and the underlying principles of medical and behavioral health integration. Develops effective collaborative partnerships with internal departmental colleagues (i.e. Utilization Management, Pharmacy and others).

Commitment to Team Culture

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

Communication with IEHP Members which includes intensive telephone use; word processing involving computer keyboard and screens, automobile travel within the Inland Empire.