Care Management Director (RN or LCSW)

We have an opportunity to join the Alliance as the Care Management Director leading the Care Management Department. 

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Health Services Officer, this position: 

• Provides strategic management oversight in implementing, directing, and monitoring the Alliance’s Care Management functions, including Behavioral Health, Care Coordination, Care Management (Adult Complex Case Management and Pediatric Case Management inclusive of California Children’s Services), in alignment with Medi-Cal, Knox-Keene and other regulatory and accreditation standards
• Directs the Care Management Department, acts as a subject matter expert, and provides executive level advice and guidance on Care Management issues and overall business operations
• Directs, manages, and supervises Care Management Department staff

ABOUT THE TEAM

Our mission is to coordinate care and empower members to achieve their health and wellness goals through collaboration and by facilitating member relationships with community providers.

WHAT YOU'LL NEED TO BE SUCCESSFUL

To read the full position description, and list of requirements click here. 

• Knowledge of:
  • Complex practices, issues and theoretical principles related to community care coordination, including behavioral health
  • Principles and practices of Care Management and Care Coordination
  • Principles and practices of clinical nursing or social work, as applicable to license type
  • Promoting and applying change management principles
  • Principles and practices of program development, process improvement, and project management
• Ability to:
  • Direct, manage, supervise, mentor, train and evaluate the work of staff
  • Develop, plan, organize and direct programs and activities that are complex in nature and regional in scope
  • Provide leadership, facilitate meetings, and partner with and guide managers and employees in the resolution of issues that are complex and may have considerable impact
  • Attend in person meetings with community partners, providers, and hospitals
  • Foster effective working relationships, influence others, negotiate and persuade others, and build consensus with individuals at all levels in the organization
  • Demonstrate a collaborative management style, build rapport, and effectively manage internal and external business relationships including members of the medical community, community agencies, and board members
• Education and Experience (RN):
  • Current and unrestricted license as a Registered Nurse issued by the state of California
  • Bachelor’s degree in Nursing, Behavioral Health or Social Science
  • A minimum of ten years of relevant experience in the clinical aspects of managing a Care Management, Health Education, Utilization Management, or Quality Improvement program with demonstrated experience in process improvement and project management and including three years of management-level experience (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying
• Education and Experience (LCSW):
  • Current and unrestricted license as a Licensed Clinical Social Worker issued by the state of California
  • Master’s degree in Social Work
  • A minimum of eight years of relevant experience in the clinical aspects of managing a Care Management, Health Education, Utilization Management, or Quality Improvement program with demonstrated experience in process improvement and project management and including three years of management-level experience; or an equivalent combination of education and experience may be qualifying

OTHER INFORMATION

• We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below. 

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).