The Children and Families Specialty Plan is looking to hire a Regional Care Management Director to lead the care management team in Medicaid Regions 1 and 2 in the state of North Carolina. This People Leader will be responsible for the Children and Families Specialty Plan integrated physical health and behavioral health care manager teams and the development, implementation, and coordination of a comprehensive clinical program designed specifically to manage the health and wellness outcomes of youth in foster care and adoption assistance, including highly complex members with varying degrees of medical and behavioral health complexity and acuity. This position will work remotely with Regions 1 and 2. (The internal company title is Director of Special Programs and Services)
How you will make an impact:
Responsible for providing oversight and leadership of a Care Management and Care Coordination programs and program operations within two of the six North Carolina Medicaid Regions of the statewide CFSP Care Management model. This responsibility includes required coordination and colocation with local County DSS agencies within the respective regions.
Responsible for the overall oversight of the CFSP Care Management teams within assigned regions. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Sets strategy and executes on performance drivers, including alignment with contractual requirements, addressing goals, gaps in care, transitions, social determinates of health (SDOH), and other strategies that support comprehensive, integrated care planning.
Supervise and support Care Management Supervisors to lead, develop, and implement clinical and non-clinical activities that impact health care quality cost and outcomes.
Coordinates and collaborates with staff of the North Carolina DHHS and its divisions to ensure clinical programs, policies and programs are aligned with member needs.
In collaboration with other CFSP team members, develops metrics for monitoring program objectives, policies, and procedures that support regulatory and accreditation standards compliance; identifies training priorities and needs for staff and collaborates to address those priorities and meet the needs; develops and executes population health strategies; Informs network development and provider needs; identifies needs for community and other support programs, resources and linkages.
Identifies and develops opportunities for innovation to increase effectiveness and quality.
Provide innovative approaches while leading a dedicated team of professionals to work collaboratively to make a difference in the lives of those we serve.
Travel within your assigned regions is estimated at 25% with periodic overnight travel
Requires a BA/BS and minimum of 8 years experience in a related field, including prior management experience and clinical, quality, and/or utilization management experience in a managed care setting; or any combination of education and experience, which would provide an equivalent background.
Preferred skills and experiences:
Reside within your assigned region. Regions 1 and 2 include these counties: Avery Buncombe Burke Caldwell Cherokee Clay Graham Haywood Henderson Jackson Macon Madison McDowell Mitchell Polk Rutherford Swain Transylvania Yancey, Alleghany Ashe Davidson Davie Forsyth Guilford Randolph Rockingham Stokes Surry Watauga Wilkes Yadkin
5+ years of Care Management/population health experience in a healthcare organization serving Medicaid beneficiaries with a focus on integrated care for children and youth.
5+ years of experience working with children, youth and families served by the child welfare system and/or familiarity with the State agencies that are involved with their care (e.g., DSS, Department of Public Instruction, Division of Juvenile Justice and Delinquency Prevention, DMH/DD/SUS).
Management experience of clinical and non- clinical staff serving the children and youth involved with Juvenile Justice, Social Services, etc.
Strong leadership and team management skills with a demonstrated ability to develop and implement care management programs.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
