• Provides leadership and management of outcomes organizationally and for areas of responsibility. 
• Coordinates collaborative interdisciplinary strategies for Regulatory preparation and processes for ongoing compliance with regulatory standards. 
• Provides safe practices for patients in all aspects of patient care activities. 
• Plan implements, and maintains an effective clinical case management model
• Oversee, direct, and guide the organization towards achieving current & future goals
• Ensure that all organizational activities and operations comply with Local, State, and Federal regulations, JCAHO standards and laws governing healthcare operations
• Provide clear and consistent communication and direction to team/staff/employees
• Manage interpersonal relationships and managing self
• Contribute to the development of the departmental budget and actively facilitate the achievement of budgeted goals and cost objectives and the ongoing evaluation of results
• Manage and implement a comprehensive case management program
• Maintain accountability for the Compliant Documentation Management Program
• Provide exemplary leadership in a time of rapid growth and change
• Evaluate, benchmark and improve productivity standards and metrics
• Build relationships and cultivate networks
• Influence and negotiate contracts
• Implement strategies to achieve business and financial success
• Performs secondary scheduling functions for the team, including monthly schedule creation, daily changes and management, and assigning the appropriate Caregiver and Client fits

Skills: Strategic Leadership, Regulatory Compliance, Communication, Relationship Management, Budget Oversight, Case Management, Contract Negotiation, Productivity Improvement

• Supervises the work of assigned personnel by assigning and reviewing work, providing guidance and training, and conducting performance evaluations.
• Develops and implements case management programs, including utilization review and admission or discharge planning.
• Plans, develops, and manages department strategies and operational budgets. 
• Prepares and submits budget and related reports. 
• Forecasts expenses and approves expenditures.
• Plans and implements performance improvement strategies for case management.
• Works collaboratively with Case Managers to serve patients and provides best practices consultation and guidance.
• Works collaboratively with Emergency and Inpatient directors to assists and facilitate patient’s needs such as transfers and admissions of patients in ED and Inpatient.
• Prepares and distributes status and statistical reports of activities. 
• Oversees utilization reviews and caseload audits.
• Ensures compliance with patient medical records and information privacy regulations, including medical data confidentiality and security.
• Acts as liaison between clients and outside agencies, institutions, homes, and facilities. 
• Coordinates with various departments regarding referrals, screenings, and treatments.
• Collects, analyzes, and responds to medical and healthcare data from internal and external sources.
• Receives and responds to patient complaints researches issue for corrective action and identifies alternative solutions
• Participates in a variety of meetings and committees to collaborate on enhancement opportunities for patient care services.
• “Leads” the Lead Caregiver Program through hands-on training, continuing education, client updates, and mentorship

Skills: Staff Supervision, Program Development, Budgeting, Performance Optimization, Team Collaboration, Patient Transfers, Compliance Management, Data Reporting

• Oversee onboarding & ongoing training of Care Managers in conjunction w/ Senior Care Managers.
• Using the resources of Corporate Services as energy, information and credibility multipliers when working with direct reports, clients and caregivers.
• Meeting weekly with the Ops Manager and other support staff as necessary, providing updated client/caregiver information.
• Meeting weekly with the Senior Care Managers Team and Care Manager Oversight Team to discuss Care Team progress, challenges and solutions.
• Regular review of the client census and targeted use of the critical information contained therein.
• Through active review ensure that all clients have the best care experience by maintaining an exceptional level of personal care through updated Plan of Cares and excited, well trained, professional caregivers.
• Oversee the On-Call Employees and Senior Care Managers to ensure that all shifts are filled and start and end on time.
• Ensure that the Senior Care Managers Team is always prepared with a backup plan on filling all client shifts.
• Ensure that Senior Care Managers team meet or exceed standards established in P&Ps and SOPs regarding client care, caregiver development and new client starts.
• Assists with client admissions, discharges, and transfers
• Responsible for the creation and continued evaluation of comprehensive person-centered care plans
• Contributes to the physical, mental, emotional, and spiritual well-being of clients through respectful, professional, competent, and personable interactions during monthly check-ins to evaluate progress, promote continuity of care, and ensure improved health outcomes.
• Reviews client and family satisfaction, and partners with the leadership team to strategize, develop, and implement customer service initiatives
• Conducts weekly quality assurance reviews of records and charting data to assess any changes in physical, mental, or psychosocial status and reports that information to the appropriate party
• Serves as a liaison among multiple stakeholders, including administration, physicians, therapy and hospice teams, families, nursing staff, support staff, and other members of the organization to ensure all parties are up to date with client care plan information
• Facilitates the coordination of new client onboarding through the creation and implementation of person-centered training plans that will assist the Care Coordinator and Lead Caregiver program in training team of caregivers

Skills: Team Oversight, Backup Planning, Policy Compliance, Client Admissions, Care Plan Development, Client Well-being Promotion, Customer Satisfaction Strategy, Stakeholder Coordination

• Ensures the delivery of high quality services consistent with professional standards and excellent patient services.
• Develops annual department budget and business plan, is accountable for performance to budget and business plan.
• Responsible for management of clinical services and programs
• Develops, implements and revises program specific policies and procedures 
• Ensures program compliance with contracts, state and federal regulations and accreditation standards as are applicable.
• Directs and assists in the development of grant proposals and other fundraising activities to ensure the growth and viability of the program
• Collaborates with community agencies to enhance services to people living with HIV/AIDS.
• Networks within the community and is current on issues and activities which occur locally and on the state and national level as they relate to AIDS funding, treatment of persons with HIV/AIDS and relevant research issues.
• Identifies community need for existing and new services, implements program modifications or enhancements 
• Creates an environment that promotes individual accountability, staff development and staff satisfaction with work environment.
• Work with RN to ensure care plans are up to date and being implemented
• Check in with caregivers and clients on a monthly basis to continue meeting the needs of all parties
• Perform in person or virtual visits to clients as well as introducing the caregiver to the client on the first day
• Perform service inquiries, assessments and client acquisition protocol

Skills: Clinical Program Management, Policy Development, Regulatory Compliance, Grant Writing, Community Collaboration, Needs Assessment, Staff Development, Client Engagement

• Provides leadership and direction for all Case Management and Social Work Services employees at assigned site including hospital based, clinic services, outpatient settings as well as the emergency department
• Develops and sustains case management or social work policies and procedures in collaboration with other Case Management/Social Work Services site managers
• Manages and participates in other policies in impacting utilization, reimbursement, patient care and safety as well as general hospital discharge planning performance
• Creates and performs the annual appraisals for case managers and ED / clinic social workers and completes all progressive counseling and documentation as appropriate
• Develops, recommends, and implements goals and policies for the resource management of Case Management Social Work Services
• Develops and maintains financial contracts with Executive Health resources, Milliman, White Stone and Interqual for utilization management support
• In conjunction with the Medical Advisors, assures that patient stay management is appropriate to the acute care setting and resource effective
• Provides leadership education and decision-making on issues of use of length of stay fund and charity resources
• Plan and manage methods to measure, assess and identify opportunities to improve the performance of Case Management Department
• Educate hospital and medical staff on role in the Case Management process
• Oversees the coordination of patient care by monitoring and evaluating processes and services utilized to meet an individual’s needs
• Through communication and collaboration promote quality patient care and cost effective outcomes
• Plan short and long-term goals and objectives for the Case Management Department
• Manage resources and delegate projects and allocated resources to ensure excellent patient care
• Meeting all regulatory standards, maintaining compliance and adhering to The Joint Commission standards
• Personnel processes including: hiring, evaluations, counseling, coaching, terminations and staff development
• Develop, review, monitor and evaluate policies and procedures, protocols and standards in the Case Management Department

Skills: Financial Contract Management, Utilization Management, Leadership Education, Performance Improvement, Staff Training, Patient Care Coordination, Regulatory Compliance, Policy Development

• Clinical Behavioral Health experience and Behavioral Health Managed Care experience
• Thorough knowledge of the Medicaid Managed Care Organization.
• Experience working with Health Homes
• Familiar with the OMH, DOH, OASAS regulations for service delivery
• Knowledge of QM and UM activities and reporting
• Solid assessment and documentation skills
• Great interpersonal skills
• Excellent communication skills (Written and verbal)
• Strong attention to detail, highly organized
• Experience in a Behavioral Health setting

Qualifications: BA in Business Administration with 6 Years of Experience

• Extensive management and clinical experience
• Experience in improving organizational performance
• Experience in facilitating and leading multidisciplinary teams
• Strong written and verbal communication skills
• Demonstrated ability to organize and work with groups of people
• Ability to present data to professional groups and institute changes based on the data presented
• Demonstrates effective problem solving and decision-making skills
• Experience as a case manager
• Experience in a leadership role 
• Great interpersonal skills
• Solid assessment, clinical, and documentation skills

Qualifications: BA in Public Health with 3 Years of Experience

• Experience in program management and supervisory experience.
• Experience with SMI/DD population
• Knowledge of CARF standards and accreditation process.
• Ability to implement various evidence-based models (Psychosocial Rehabilitation, ACT Model, Full Service Partnership, Harm Reduction, Housing First, and Motivational Interviewing.
• Experience with MediCal documentation and billing.
• Knowledge of CCL and other state/county regulations for residential care facilities
• Experience with Human Service Information Systems
• Ability to communicate, mediate and negotiate complex issues with a high level of organizational skill.
• Experience in progressively responsible roles with demonstrated leadership experience and strong team management skills.
• Ability to work in a cross functional team setting.

Qualifications: BA in Social Work with 3 Years of Experience

• Managerial/supervisory experience in a health care setting. 
• Prior experience in an interdisciplinary setting. 
• Excellent interpersonal/listening skills to interact effectively with individuals of all backgrounds, experience and educational levels. 
• Excellent written/oral communication skills. 
• Demonstrates ability to communicate effectively with staff, physicians, and other allied health professionals. 
• Must be able to function effectively under stress. 
• Must have a general working knowledge of computers and department specific software
• Must be comfortable operating in a collaborative, shared leadership environment. 
• Effectively face-to-face, telephone and computer methods.
• Strong attention to detail, highly organized and ability to maintain accuracy under time constraints.

Qualifications: BA in Health Care Administration with 4 Years of Experience

• Demonstrated hands-on leadership and operational responsibility in a large/complex healthcare environment 
• Experience of successful management experience and in-depth understanding of managed care
• Experience in budgeting and strategic planning of goals and objectives
• Experience in statistical analysis and construction of reporting system.
• Thorough knowledge of managed care utilization and quality management activities and requirements.
• Experience in healthcare compliance management
• Experience managing a variety of case management models using an interdisciplinary team approach.
• Understands financial impact of efficient resource management.
• Ability to hire, train and coach employees.
• Demonstrate understanding of competency-based criteria for case management.
• Ability to manage a complex, multiple hospital case management program
• Health System experience

Qualifications: BA in Nursing with 7 Years of Experience