Supervisor, Care Navigation

About CCNC

From the mountains to the coast, from large cities to small towns, Community Care of North Carolina is transforming health care. Informed by statewide data and predictive analytics, community-based care-managers work with local physicians and diverse teams of health professionals to develop whole-person plans of care that connect people to the right local resources and increase equity and access to high quality care.

CCNC Mission Statement 

To improve the health and quality of life for all North Carolinians by building supporting better community-based healthcare delivery systems.

Position Summary

Assist Director with development and implementation of the Care Navigation program including performance metrics, processes, and workflows. Drive distribution of work to ensure member engagement rates of the rising risk population and program outcomes are achieved. Collaborate between the care management, practice, quality improvement and/or provider relation teams as necessary to ensure seamless coordination of care for members. Ensure care navigation staff provide outstanding and efficient service to our members, including receiving and processing referrals from payers, practices, or members focused on Social Determinant of Health (SDOH), provide resources, screening for possible clinical needs, and referring to the clinical Care Management team as appropriate; driving members to primary care and other supports, addressing post discharge care needs, follow-up care, and preventive health services as needed.

The Supervisor, Care Navigation, will work remotely within regions to cover needs across the state.

Essential Functions

Operations

• Monitor and evaluate program measures, ensuring staff focus is placed on rising risk populations.
• Assist with developing and implementing new workflows, processes, and programs, as necessary to contribute to the program and the organization's success.
• Develop and implement a clear escalation pathway for cases that require a warm hand-off to a clinical team member.
• Supplement field-based, non-clinical care navigation, and member engagement activities as needed.
• Ensure quality and equal workload distribution to care navigation staff.
• Serve as a content expert for the team.
• Engage and maintain collaborative relationships with internal and external stakeholders.
• Arrange for Hospital/External Data System, Electronic Medical Record (EMR) system, or Health Information Exchange (HIE) system access, as necessary. Assure team members adhere to the policies, procedures and requirements of the external system supplying the Hospital/Data or EMR access.
• Utilize Hospital/Data, HIE or Electronic Medical Record system, as necessary.
• Assure team members have individual and/or team-based productivity goals to meet established performance targets that align with corporate goals and objectives.
• Adhere to CCNC Privacy and Security policies to ensure that patient and company data is properly safeguarded
• Other duties as assigned.

Quality Improvement

• Review staff documentation for adherence to quality standards and workflow processes
• Use data to drive decisions and plan/implement performance improvement strategies related to care navigation metrics and performance outcomes.
• Provide feedback to assigned team members on ways to improve the quality and effectiveness of service delivery.
• Complete quality performance audits
• Collaborate with leadership and team members to address member complaints and member survey results.

Staff Management

• Provide direct supervision of assigned care navigation staff.
• Participate in recruitment/interviewing/hiring.
• Ensure that new hires receive appropriate orientation and mentorship.
• Conduct performance evaluations.
• Maintain team accountability by empowering staff to work independently and as a team to meet company and program 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 members 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 team members are out.
• Maintain a cohesive, integ