Community Project Manager

Job Title: Community Project Manager
Reports to: Regional Project Manager or Clinical VP

I. General Purpose of Position:

AccessCare is part of the Community Care of North Carolina. A program that builds on Carolina ACCESS by assisting local providers to develop managed care delivery systems that coordinate a continuum of care with processes to influence cost and quality of care. The program is sponsored by the Division of Medical Assistance (DMA) and the North Carolina Foundation for Alternative Health Programs, Inc, and is funded, in part by the Kate B. Reynolds Health Care Trust.

AccessCare Community Project Managers will work with local providers to develop community-based managed care networks and infrastructure that will be able to meet the health care needs of the Medicaid population, while providing the State with greater budget predictability.

The primary purpose of the Community Project Manager is to ensure that AccessCare supports the missions, goals and values of the CCNC program within the community.

I. RESPONSIBILITIES AND ACCOUNTABILITIES:

• The CPM will work in concert with the AccessCare staff, the physician practices, and the community to form a framework of health services directed toward the Medicaid Carolina Access population.
• Responsible for ensuring that AccessCare supports the missions, goals, and values of the Community Care of North Carolina programs within the community
• Collaborate with the Medical Director, Clinical Vice President, Regional Project Manager, state and community health organizations, and physicians to assure coordination of Medicaid Community Care services.
• Implements strategies to promote collaborative, positive community relationships
• Recommends, coordinates and collaborates on the development of programs to meet enrollee needs based on assessments and input from consumers
• Assists in implementing developed programs and evaluating the success of each program to ensure quality and efficiency, while avoiding duplication of internal and external efforts
• Modifies programs, as appropriate, based on evaluations
• Maintains regular communication with the Medical Director, Clinical Vice President, Regional Project Manager and Advisory committee
• Develops and maintains collaborative and collegial working environment with AccessCare providers
• Maintains regular contact with physician practices, community leaders and organizations serving Medicaid recipients to enhance the effectiveness of program initiatives
• Review data submitted from DMA in terms of case reporting and cost benefits analysis
• Identify “at risk” enrollees
• Develop and implement individual care plans for those clients identified at greatest risk
• Provide direct follow-up and outreach services to “at risk” clients
• Coordinate, develop, and provide health care education programs and training that are applicable to the client and families' needs
• Work with the community to implement AccessCare disease centered initiatives
• Attends CCNC program Case Management Meetings
• Works to resolve the conflict constructively; seeks guidance regarding conflict resolution when necessary
• Perform other duties as required

II. NATURE AND SCOPE OF THE POSITION

A. Supervision Duties:

• Supervise the assigned staff. This may include the AccessCare case managers, patient support coordinator and managed care coordinator
• Supervision includes recruiting and selection of staff; ensuring staff is properly trained; defining responsibilities and expectations through performance goals and standards; providing guidance; interpreting and clarifying policies and procedures; keeping staff aware of developments and changes affecting their work; approving travel and work schedules; evaluating performance; counseling and initiating disciplinary action. There is significant effort involved in advising the staff on resolving sensitive and unusual situations.

B. Organizational Relationships

C. Scope of Responsibilities

• Budget Responsibilities: Collaborate with Business Manager, as appropriate
• Confidential Information: Responsible for maintaining confidentiality of all client and family information.
• Equipment used: Computer with various software programs such as Internet, Excel, and word processor, computer printer, digital pager, telephone, personal automobile, fax machine, copier, calculator, and paper shredder.

Make significant decisions within the standards of the position. Generally guided by established policy, and any unusual questions or problems are referred to a superior.

IV. KNOWLEDGE/SKILLS REQUIRED

Education/Experience: RN (BSN preferred) Graduation from a State accredited school of professional nursing or related clinical area. A minimum of 5 years clinical experience and two years of community based clinical experience is required. Two years of care management and managed care highly preferred. One year administrative or supervisory experience required.

• Excellent communication skills both orally and in writing
• Considerable knowledge of care management principles
• Knowledge of government, private organizations and community resources
• Skill in establishing rapport with a client and applying techniques of assessing psychosocial, behavioral, and psychological aspects of a client's problem
• Knowledge of and compliance with federal and state regulations applicable to the position
• Analytical skills necessary as independent decisions and problem solving are required
• Strong organizational and computer skills required including various office software and Internet

VI. WORKING CONDITIONS

Physical Demands - The job environment is primarily a medical office environment although patient home visits may be required. Exposure to general office and household conditions as well as communicable diseases could occur. Routinely there may be some minor physical inconveniences or discomfort in the work setting. A moderate amount of traveling/driving is required, as well as sitting for moderate periods of time. There is occasional lifting of 20-30 pounds necessary to complete a task.

Work Environment – Time will be spent visiting PCP offices, other health care providers, hospital, DSS, community organizations, and homes of clients and their families. “Hands on” clinical treatment is not permitted when performing AccessCare duties. Frequent changes are expected on a daily basis; therefore, flexibility and adaptability are needed. Evening and weekend work may be required. Travel may be part of a daily routine based on client needs and establishing community networks within the provider service area. Local travel in your personal automobile could vary between 25% - 75%. Attendance at occasional regional office meetings in the Morrisville area will be required.

Attendance at occasional Access II and III meetings at various locations across the state are required.