Job Details

Location: Remote, candidates local to Santa Barbara preferred but must reside in California. Possibility of traveling into the Santa Barbara office quarterly as needed.

Description:
The Care Management Supervisor - Adult Programs will lead both clinical and non-clinical staff in addressing the medical and psychosocial needs of members, while providing resources and facilitating connections to government programs, social services, and community resources. This role does not involve managing a personal caseload but includes overseeing the Disease Management (DM) and Case Management (CM) programs, as well as supporting staff with their individual caseloads. The Supervisor will also offer additional support to team members and other department needs, which may include:

• Supervising Adult Case Management (CM) and Disease Management (DM) staff, monitoring and evaluating productivity.
• Ensuring effective and timely communication between staff, members, providers, and community-based organizations.
• Providing staff training and development.
• Addressing and resolving staff-related issues.
• Identifying opportunities for program improvement.

What You Will Do:

• Lead, mentor, and supervise CM and DM staff, ensuring ongoing development for both new and experienced team members. This includes setting goals, conducting performance appraisals, and managing time-off requests and productivity.
• Collaborate with management to conduct annual reviews and implement necessary disciplinary actions.
• Address and resolve daily issues, concerns, and conflicts among unit staff.
• Work closely with CM Leads to train and mentor new team members.
• Assist in coordinating staff assignments and coverage to ensure timely completion of member-centered assessments, reassessments, and care plans, addressing medical, psychosocial, rehabilitation, and environmental needs.
• Participate in internal and external audits as required.
• Partner with Behavioral Health Management to identify, develop, and implement behavioral health initiatives, as directed by the CM Manager, to enhance care coordination for members with behavioral health needs.
• Identify workflow inefficiencies and collaborate with management to address and resolve them.
• Collaborate with colleagues across departments, as needed or directed by the department Manager.
• Build and maintain relationships with community organizations to facilitate referrals, advocacy, and follow-up, with a focus on achieving care plan goals as directed by the department Manager.
• Assist with addressing member concerns and grievances.
• Identify issues within established CM processes, policies, or procedures, and propose solutions for efficient resolution.
• The CM Supervisor may manage a caseload when directed by the CM Manager, if deemed necessary.
• Based on the needs identified in an assessment, arrange, coordinate, and monitor services from various providers to meet the member's needs.
• Conduct follow-up to monitor the member's needs and care plan, and develop a support system for the member.
• Evaluate the member holistically to identify functional limitations that impact independent living.
• Provide resources and linkages for crisis management support.
• Develop individualized, member-centered care plans as needed.
• Consult with Clinical Managers and the Director on medical issues when appropriate.
• Refer members to specialized programs such as California Children's Services (CCS), Tri County Regional Center (TCRC), County Behavioral Wellness, Public Health, Local Educational Agency (LEA), In-Home Waiver, Family Service Agency (FSA), etc.
• Assist with placements in alternative living arrangements, including SNF, board and care, shelters, etc.
• Conduct home visits as necessary to assess the home situation.
• Maintain a high level of ethical conduct and comply with HIP nd confidentiality regulations.
• Participate in continuing education and stay current in areas of expertise.
• Perform other duties as assigned.

You Will Be Successful If:

• Proven expertise and capability to function effectively as a case manager.
• Strong ability to communicate and negotiate clearly and effectively with members, their families or support systems, physicians, and other healthcare providers.
• Self-motivated and committed to seeking knowledge to enhance both personal and professional performance.
• Ability to collaborate and work effectively within a cross-functional team environment.
• Proficient in computer literacy and technical skills.
• Exceptional verbal communication and writing abilities.
• Willingness and ability to travel outside the office and attend meetings during and after regular work hours.
• Must hold a current, valid driver's license with a clean driving record.
• Regular attendance is critical to performing this role.

What You Will Bring:

• Current, active, and unrestricted California Registered Nurse (RN) License or Licensed Clinical Social Worker required.
• Bachelor's degree required; a degree in Nursing, Public Health, Community Health, Disease Management, Epidemiology, Health Care Administration, or a related field is preferred. Master's Degree or higher preferred.
• A minimum of five (5) years of clinical work experience, preferably in one of the above-mentioned fields required.
• 2+ years of clinical work experience in a lead or supervisory role required.
• A minimum of two (2) years of managed care experience, with preference given to experience in Medi-Cal managed care required.
• Understanding of managed care issues, including benefits and contract limitations, delivery systems, reimbursement processes, and the role of medical management activities preferred.
• Familiarity with State and Local social service agencies and community-based organizations preferred.
• Current certification in crisis prevention and intervention preferred.
• Knowledge and expertise in community-based behavioral health care resources preferred.
• Bilingual in English and Spanish preferred.
• Certification from the Commission for Case Manager Certification (CCMC) preferred.

About Impresiv Health:
Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.

Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do - provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.

That's Impresiv!