Director of Community Based Care Management
CBH's Community Based Care Management Programs play a critical role in coordinating care to produce better outcomes for those with complex medical, behavioral health and social needs.
The Director:
Community Based Care Management (CBCM) is responsible for shaping and implementing the vision for and assessing the performance of CBH's CBMC interventions.
The Director of CBCM utilizes their education, experience with and knowledge of models of integrated care to oversee integrated whole-person healthcare programs to interface with health system partners, oversee the daily operations of the child and adult CBCM and to ensure the standards of care and practices are being delivered in accordance with state regulation guidelines.
The Director ensures that the teams deliver patient-centered care coordination, collaboration with physical health partners as well as community-based organizations (CBOs), employ evidence-based practice and quality improvement approaches, and utilize informatics to guide delivery of CBCM interventions.
The Integrated Care Program (ICP), which started in 2016, provides incentives based on integrated health measures to enhance the coordination of care between physical health MCOs, behavioral health primary contractors and MCOs, and providers, for specific populations with both behavioral health and physical health conditions.
A collaborative approach to integrated care, Integrated Care Pans must be created for eligible members by both the physical health and behavioral health MCO.
There are numerous other components to this program, such as the exchange of hospital admission and discharge data, and measurement of the impact of the program on 10 associated performance measures.
The Director is responsible for implementing the state mandates and requirements of the ICP program, as well as assessing the performance and impact of the program.
This requires using education, knowledge, and experience in operationalizing ICP or similar programs, interfacing with health care system partners, working with respective external and internal CBH teams on creating interventions that might impact the associated performance measures, as well as program evaluation skills.
The ICP director also ensures that the day-to-day operations of the ICP team/s are being delivered in accordance with state regulation guidelines.
Essential Functions:
Works with the Senior Director to shape and implement the vision for CBCM teams across pediatric and adult populations.
Works with the Senior Director to shape and implement the ICP program according to state mandates and requirements.
Act as designee for Senior Director for the ICP and CBCM programs Responsible for the daily operational and leadership aspects of the CBCM and IPC teams.
Act as liaison to external stakeholders as needed.
Responsible for clinical data and outcomes monitoring and reporting as well as ensuring compliance with state regulatory and accreditation requirements.
Uses continuous quality improvement techniques to actively manage and ensure the efficacy of CBH's CBCM and ICP team interventions.
Works collaboratively with the Clinical Department and other departments to research, develop and implement interventions that target the ICP performance measures.
Provide clinical supervision for coordinators regarding specific cases for appropriate care coordination, referrals to Community Based Organizations and referrals to Certified Peer specialists.
Leads problem solving for members who present with crisis issues when Supervisors and Care Managers have exhausted appropriate interventions.
Facilitate learning opportunities during departmental meetings regarding CBCM programs as well as the ICP program.
Manage workforce planning including hiring, performance improvement plans, coaching, and disciplinary action in conjunction with Senior Director and Human Resources.
Use a holistic and resiliency approach in leadership and training related to identification of physical health and social determinants affecting an individual member's care.
Develop and facilitate intradepartmental and interdepartmental workgroups to ensure integration of care, identification of opportunities for improved resource management and improved communication between and among other senior leadership levels, Physician Advisors, Coordinators, and clinical staff.
Assist with development and implementation of clinical/financial interventions to ensure budget compliance.
Ensure compliance with all established policies and procedures and recommend changes as needed.
Lead clinical efforts during reviews with Office of Mental Health and Substance Abuse Services, Mercer, and National Committee for Quality Assurance.
Organize, prepare, and disseminate clinical and quality data to be incorporated into daily decision making and to guide interventions.
Develop new integrated care opportunities, i.
e.
by expanding existing CBCM program collaborators with new sites, and/or the development of new community based integrated care coordination programs focusing on specific populations.
Model and require exceptional customer service in work with members and providers.
Develops and delivers expectations for maximum productivity of clinical staff.
Performs other duties as assigned.
Position Requirements:
Education:
Doctor of Behavioral Health (DBH) preferred such as PH.
D or PsyD in Psychology, PhD in Public Health, PhD in Health Policy ; and associated doctoral degrees/ Master's degree in social work or related field with a minimum of 5 years of relevant integrated care leadership experience accepted License/Certification:
License preferred; PA Child Abuse Clearance required Relevant Work
Experience:
Minimum of 5 years of post-graduate experience with a minimum of 5 years of supervisory experience 2 of which would include managing through a subordinate manager.
Integrated care knowledge and experience required.
Knowledge of health care policy, whole person care models and the PA Health Choices program preferred.
Skills:
Strong verbal and written communication and presentation skills Strong analytic skills; able to read, analyze, interpret, can create utilization and other related data reports Prepare and present various PowerPoint presentation and programs , initiative and outcomes to committees , other departments, and executive leadership Understanding of mental health and substance abuse services or interventions General knowledge of integrated behavioral and physical health care approaches and policies with an interest in ongoing professional development regarding these topics General understanding of and familiarity with social determinants of health, as well as health disparities affecting our members Proficient in MS Office and able to type at least 20 words per minute Able to work collaboratively in team settings Strong organizational skills Compliant with HIPAA regulations Strong clinical skills Ability to provide clinical supervision related to clinical presentations of CBH members Critical thinking and proactive problem-solving abilities Strong leadership and team management skills fostering a positive, welcoming, culturally competent as well as productive work environment Covid-19 Vaccine Requirement:
The safety and well-being of our candidates, our people, and their families continues to be a top priority.
Subject to appPI226508763 Recommended Skills Analytical Behavioral Medicine Care Coordination Clinical Supervision Clinical Works Communication Estimated Salary: $20 to $28 per hour based on qualifications.
The Director:
Community Based Care Management (CBCM) is responsible for shaping and implementing the vision for and assessing the performance of CBH's CBMC interventions.
The Director of CBCM utilizes their education, experience with and knowledge of models of integrated care to oversee integrated whole-person healthcare programs to interface with health system partners, oversee the daily operations of the child and adult CBCM and to ensure the standards of care and practices are being delivered in accordance with state regulation guidelines.
The Director ensures that the teams deliver patient-centered care coordination, collaboration with physical health partners as well as community-based organizations (CBOs), employ evidence-based practice and quality improvement approaches, and utilize informatics to guide delivery of CBCM interventions.
The Integrated Care Program (ICP), which started in 2016, provides incentives based on integrated health measures to enhance the coordination of care between physical health MCOs, behavioral health primary contractors and MCOs, and providers, for specific populations with both behavioral health and physical health conditions.
A collaborative approach to integrated care, Integrated Care Pans must be created for eligible members by both the physical health and behavioral health MCO.
There are numerous other components to this program, such as the exchange of hospital admission and discharge data, and measurement of the impact of the program on 10 associated performance measures.
The Director is responsible for implementing the state mandates and requirements of the ICP program, as well as assessing the performance and impact of the program.
This requires using education, knowledge, and experience in operationalizing ICP or similar programs, interfacing with health care system partners, working with respective external and internal CBH teams on creating interventions that might impact the associated performance measures, as well as program evaluation skills.
The ICP director also ensures that the day-to-day operations of the ICP team/s are being delivered in accordance with state regulation guidelines.
Essential Functions:
Works with the Senior Director to shape and implement the vision for CBCM teams across pediatric and adult populations.
Works with the Senior Director to shape and implement the ICP program according to state mandates and requirements.
Act as designee for Senior Director for the ICP and CBCM programs Responsible for the daily operational and leadership aspects of the CBCM and IPC teams.
Act as liaison to external stakeholders as needed.
Responsible for clinical data and outcomes monitoring and reporting as well as ensuring compliance with state regulatory and accreditation requirements.
Uses continuous quality improvement techniques to actively manage and ensure the efficacy of CBH's CBCM and ICP team interventions.
Works collaboratively with the Clinical Department and other departments to research, develop and implement interventions that target the ICP performance measures.
Provide clinical supervision for coordinators regarding specific cases for appropriate care coordination, referrals to Community Based Organizations and referrals to Certified Peer specialists.
Leads problem solving for members who present with crisis issues when Supervisors and Care Managers have exhausted appropriate interventions.
Facilitate learning opportunities during departmental meetings regarding CBCM programs as well as the ICP program.
Manage workforce planning including hiring, performance improvement plans, coaching, and disciplinary action in conjunction with Senior Director and Human Resources.
Use a holistic and resiliency approach in leadership and training related to identification of physical health and social determinants affecting an individual member's care.
Develop and facilitate intradepartmental and interdepartmental workgroups to ensure integration of care, identification of opportunities for improved resource management and improved communication between and among other senior leadership levels, Physician Advisors, Coordinators, and clinical staff.
Assist with development and implementation of clinical/financial interventions to ensure budget compliance.
Ensure compliance with all established policies and procedures and recommend changes as needed.
Lead clinical efforts during reviews with Office of Mental Health and Substance Abuse Services, Mercer, and National Committee for Quality Assurance.
Organize, prepare, and disseminate clinical and quality data to be incorporated into daily decision making and to guide interventions.
Develop new integrated care opportunities, i.
e.
by expanding existing CBCM program collaborators with new sites, and/or the development of new community based integrated care coordination programs focusing on specific populations.
Model and require exceptional customer service in work with members and providers.
Develops and delivers expectations for maximum productivity of clinical staff.
Performs other duties as assigned.
Position Requirements:
Education:
Doctor of Behavioral Health (DBH) preferred such as PH.
D or PsyD in Psychology, PhD in Public Health, PhD in Health Policy ; and associated doctoral degrees/ Master's degree in social work or related field with a minimum of 5 years of relevant integrated care leadership experience accepted License/Certification:
License preferred; PA Child Abuse Clearance required Relevant Work
Experience:
Minimum of 5 years of post-graduate experience with a minimum of 5 years of supervisory experience 2 of which would include managing through a subordinate manager.
Integrated care knowledge and experience required.
Knowledge of health care policy, whole person care models and the PA Health Choices program preferred.
Skills:
Strong verbal and written communication and presentation skills Strong analytic skills; able to read, analyze, interpret, can create utilization and other related data reports Prepare and present various PowerPoint presentation and programs , initiative and outcomes to committees , other departments, and executive leadership Understanding of mental health and substance abuse services or interventions General knowledge of integrated behavioral and physical health care approaches and policies with an interest in ongoing professional development regarding these topics General understanding of and familiarity with social determinants of health, as well as health disparities affecting our members Proficient in MS Office and able to type at least 20 words per minute Able to work collaboratively in team settings Strong organizational skills Compliant with HIPAA regulations Strong clinical skills Ability to provide clinical supervision related to clinical presentations of CBH members Critical thinking and proactive problem-solving abilities Strong leadership and team management skills fostering a positive, welcoming, culturally competent as well as productive work environment Covid-19 Vaccine Requirement:
The safety and well-being of our candidates, our people, and their families continues to be a top priority.
Subject to appPI226508763 Recommended Skills Analytical Behavioral Medicine Care Coordination Clinical Supervision Clinical Works Communication Estimated Salary: $20 to $28 per hour based on qualifications.
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