Supervisor, Care Navigation

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Support the Director in the creation and execution of the Care Navigation program, which includes performance metrics, processes, and workflows.

• Facilitate the distribution of tasks to ensure that engagement rates among the rising risk population are met and desired program outcomes are achieved.

• Collaborate with care management, practice, quality improvement, and/or provider relations teams as needed to guarantee seamless care coordination for members.

• Ensure that care navigation staff deliver exceptional and efficient services to our members, including the receipt and processing of referrals from payers, practices, or members that focus on Social Determinant of Health (SDOH).

• Provide resources, conduct screenings for potential clinical needs, and refer to the clinical Care Management team as appropriate; guide members toward primary care and other supports, addressing post-discharge care needs, follow-up care, and preventive health services as required.

• Monitor and assess program metrics, ensuring that staff prioritize rising risk populations.

• Assist in the development and implementation of new workflows, processes, and programs as needed to enhance the program and contribute to the organization’s success.

• Create and implement a clearly defined escalation pathway for cases that necessitate a warm hand-off to a clinical team member.

• Supplement field-based, non-clinical care navigation and member engagement activities as required.

• Ensure quality assurance and equitable workload distribution among care navigation staff.

• Foster and maintain collaborative relationships with both internal and external stakeholders.

• Ensure that team members comply with the policies, procedures, and requirements of the external systems that provide Hospital/Data or EMR access.

• Utilize Hospital/Data, HIE, or Electronic Medical Record systems as necessary.

• Ensure team members have individual and/or team-based productivity goals that align with established performance targets consistent with corporate goals and objectives.

• Comply with CCNC Privacy and Security policies to ensure the protection of patient and company data.

⛳️ Requirements

• Graduation from an accredited nursing school as a Registered Nurse.

• Bachelor of Science in Nursing (BSN) is preferred.

• Must possess an active, unrestricted RN license to practice in North Carolina.

• A minimum of two years of case/care management experience or relevant healthcare experience is required.

• Certification as a Certified Case Manager (CCM) is required.

• Must meet the licensure or educational eligibility criteria set by The Commission for Case Management Certification.

• Ability to gain and maintain access to Hospital/Data or Electronic Medical Record systems is essential.

• A valid driver’s license with current auto liability insurance is required.

• For Social Workers, a Master of Social Work (MSW) is required, and Licensure as a Clinical Social Worker (LCSW) is also required.

• A minimum of two years of case management experience or relevant healthcare experience is required.

• CCM certification is preferred and should be obtained within two years of hire.

• Ability to gain and maintain access to Hospital/Data or Electronic Medical Record systems is essential.

• A valid driver’s license with current auto liability insurance is required.

🏝️ Benefits

• Make a significant impact on youth and families throughout North Carolina.

• Collaborate with a supportive and cooperative care team.

• Enjoy a competitive benefits package that begins on the first day of employment.

• Take advantage of opportunities for growth, training, and bonus incentives.