Regional Project Manager

Job Title: Regional Project Manager
Reports to: Medical Director/Clinical VP

I. GENERAL PURPOSE OF POSITION:

AccessCare is part of 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.

AccessCare Regional Project Managers (RPM) 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 Regional Project Manager is responsible for working with the Medical Director and Clinical Vice President to coordinate and develop a vision, strategic plan and operational plan with which to operate AccessCare.

The principle purpose of the Regional Project Manager is to ensure that AccessCare supports the missions, goals and values of Community Care of North Carolina.

II. RESPONSIBILITIES AND ACCOUNTABILITIES:

• The RPM will work in concert with the AccessCare Case Managers, their 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 CCNC programs
• Responsible for working with the Medical Director and Clinical VP to coordinate and develop a vision, strategic plan and operational plan with which to operate AccessCare
• Collaborate with the Medical Director, Clinical VP, state and community health organizations, AccessCare Case Managers, and the health educator to assure coordination of Medicaid Community Care Plan services.
• Work with the Business Director/Human Resources to assist with supervision of administrative operations
• Work as a liaison on state and local levels concerning Medicaid health initiatives.
• Assists the Medical Director and Clinical VP with coordinating the members and agendas of various committees
• Demonstrate continued professional development and managerial development
• 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 AccessCare Medical Director and Clinical VP
• Maintains regular contact with physician practices, community leaders and organizations serving Medicaid recipients to enhance the effectiveness of program initiatives
• Seeks out and participates in educational programs and community experiences that increase professional competency
• Develops and maintains collaborative and collegial working environment with AccessCare providers
• Attends CCNC program Case Management Meetings
• Develop and implement an “at-risk” screening instrument that identifies both medical and social risk factors
• Assist database consultants with the development of an Access database system (various tables, tickler files, computer generated files) for AccessCare
• Conduct bi-monthly meetings with the AccessCare Case Managers
• Perform other duties as required

III. NATURE AND SCOPE OF THE POSITION

A.Supervision Duties:

• Supervise the assigned staff. This may include local care managers as well as data entry specialists.
• Supervision includes recruiting and selecting 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, family and employee personnel 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.

V. KNOWLEDGE/SKILLS REQUIRED

• Education/Experience: RN or other Clinical degree with Bachelors in health related field required and Masters in health related field 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.
• Must possess a valid NC Driver's License and valid clinical NC License as appropriate.

• 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

VII. WORKING CONDITIONS

Physical Demands - The job environment is primarily a general office environment as well as a medical office environment. Exposure to general office and 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 others as deemed necessary. “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 organizational needs and establishing community networks within the provider service area. Local travel in your personal automobile could vary between 25% - 75%. Attendance at occasional Access II and III meetings at various locations across the state are required.