Maternal Health Program Manager

Position Summary

CCNC is contracted with Prepaid Health Plans (PHPs) to provide statewide oversight of Local Health Department delegated care management to support children 0-5 and high-risk pregnant CCPN attributed members. CCNC is required to support the care management of the above populations for Healthy Blue, Medicaid Direct and in geographical areas when the CCPN affiliated Local Health Department cannot provide sufficient coverage.

The Maternal Child Health Program Manager is responsible for ensuring fidelity to the Maternal & Child Care Management model by assisting senior director with PHP, LHD and CCNC Care management staff collaboration to develop and implement a seamless, consistent workflow that drives success as evidenced by Service Level Agreement performance.

The Manager will oversee LHD and internal care management to ensure adherence to the Maternal & Child Health Policy Manual which includes comprehensive, cost effective, high quality, coordinated physical health, behavioral health, and social services while achieving Care Management program outcomes and process metrics.

Essential Functions

Operations Provide effective leadership in staff management with respect to recruitment, selection, retention, training, evaluation, and continued professional and educational development, and communication. In collaboration with the senior director and other CCNC team members, develop performance drivers, policies, and procedures that align with contractual requirements and promote population health improvement.

Assist with development and implementation of new processes, tools, workflows, and guidance, as necessary to ensure contract adherence and success of the organization. Supervise and support Local Health Department Supervisors to lead, develop, and implement clinical and non- clinical activities that impact health care quality cost and outcomes.

Participation in cross-functional workgroups and stakeholder meetings created to maintain and enhance program success. Ensure standards are transparent and applied consistently, impartially and ethically across all staff members. 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. Extract and analyze data to monitor performance and promote improved quality. Develop quality improvement strategies to manage and improve performance at the LHD and internal care management level.

Support staff with documentation & analytics platform needs, working with Senior Director to identify, develop and implement plans that address the development needs and train staff on enhancements. Adhere to CCNC Privacy and Security policies to ensure that patient and company data is properly safeguarded Other duties as needed to support Senior Director and LHD leadership to achieve a successful programs under this new model design and improved health outcomes for the Maternal & Child populations.

Quality Improvement Use data to drive decisions and plan/implement performance improvement strategies related to Care Management metrics for assigned members Provide feedback to LHD and internal care managers on ways to improve the quality and effectiveness of service delivery Collaborate with appropriate leadership and team members to address member complaints.

Staff Management Provide direct supervision of assigned CCNC care managers. Liaise with LHD leadership to engage in performance monitoring and quality improvement for LHDs who are serving delegated members Participate in recruitment/interviewing/hiring as needed Ensure that new hires receive appropriate orientation and mentorship Mentor and coach staff to facilitate growth for performance improvement Conduct performance evaluations on direct reports.

Maintain team accountability by empowering staff to work independently and as a team to meet company and departmental deadlines, objectives, and targets Develop and monitor coaching and Performance Improvement Plans (PIP) with team members as needed Provide ongoing staff development Provide conflict resolution with staff Ensure team member adherence to policies and procedures Disseminate communication and facilitate team meetings Approve time sheets, expense, mileage reimbursements, and other administrative duties as required Coordinate coverage when a team member is out Maintain a cohesive, integrated, well informed, and educated team Qualifications Minimum bachelor’s degree Must have licensure as an RN.

Must have three (3) years of experience providing care management, case management, or care coordination to maternal and/or pediatric populations OR three (3) years managing/supervising care management of these populations. CCM certification required At least 3 years of management/supervisor experience Knowledge, Skills, and Abilities Advanced knowledge and understanding of office applications, including MS Office (Word, Excel, Power Point, Outlook) is required, as well as internet and digital literacy Excellent communication skills – oral and written Critical thinking skills, effective clinical judgment, independent decision-making, change management skills, and problem-solving abilities Skilled in establishing rapport with members, providers, and community partners either in person or via telephone Strong organizational and time management skills Coaching, team building and supervisory skills Ability to work independently and function as an integral part of the team Motivational Interviewing skills and knowledge of adult learning and teaching principles Sensitivity to diversity of cultures, language barriers, health literacy, and educational levels Clinical competence in disease management and Care Management principles Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives Ability to shift strategy or approach in response to the demands of a situation Perform all other duties as requested Working Conditions Multiple contacts are required with various members, providers, multi-payer systems and community partners to ensure coordination of services; exposure to general office and household conditions, as well as communicable disease could occur Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds Travel using personal vehicle may be required within the State