Top 83 Director of case management Jobs in Raleigh Nc

Clinical Quality Analyst (Full-time Remote, North Carolina Based)
Alliance Health —Morrisville, NC
- $79,425 - $101,267 a year
- Full-time
- Remote
- LMFT
- Nursing
- RN License
- Disability insurance
- Health insurance
Senior Director of Reentry
Arise Collective —Raleigh, NC
- $95,000 - $110,000 a year
- Full-time
- Doctoral degree
- Licensed Clinical Social Worker
- 11+ years
- Health insurance
- Dental insurance
Care Management Consultant (Full-time Remote, NC Based)
Alliance Health —Morrisville, NC
- $68,227 - $86,990 a year
- Full-time
- Remote
- Experience working with individuals with developmental disabilities
- Nursing
- Microsoft Excel
- Disability insurance
- Health insurance
11d
Social Worker III - Continuous Quality Improvement Trainer
Johnston County, NC —Johnston County, NC
- $61,983.02 - $105,371.14 a year
- Urgently hiring
- Background check
- Master of Social Work
- Pass drug screening
- Paid holidays
- Health insurance
Social Worker III - Continuous Quality Improvement: Quality Assurance Adult Services
Johnston County, NC —Johnston County, NC
- $61,983.02 - $105,371.14 a year
- Urgently hiring
- Background check
- Google Workspace
- Master of Social Work
- Paid holidays
- Health insurance
Income Maintenance Supervisor III - Medicaid Program Manager
Johnston County, NC —Johnston County, NC
- $61,983.02 - $105,371.14 a year
- Urgently hiring
- Background check
- Pass drug screening
- Adults
- Paid holidays
- Health insurance
Board Certified Behavior Analyst (BCBA) - Hybrid
Butterfly Effects —Raleigh, NC
- $90,000 - $112,000 a year
- Full-time
- Hybrid work
- Experience working with children
- Children
- Psychology
- Continuing education credits
- Health savings account
Quick Apply
Board Certified Behavior Analyst (BCBA) - Center Based
Butterfly Effects —Cary, NC
- $90,000 - $112,000 a year
- Full-time
- Clinic
- Experience working with children
- Children
- Continuing education credits
- Health savings account
Quick Apply
Board Certified Behavior Analyst (BCBA) - Hybrid
Butterfly Effects —Durham, NC
- $90,000 - $112,000 a year
- Choose your own hours
- Experience working with children
- Children
- Psychology
- Continuing education credits
- Health savings account
Quick Apply
Senior Lead Board Certified Behavior Analyst (BCBA)
Learn & Leap Autism Center —Cary, NC
- $85,000 - $90,000 a year
- Full-time
- Background check
- 3 years
- Master's degree
- Relocation assistance
- Health insurance
Quick Apply
Licensed Mental Health Counselor
Lavni Inc —North Carolina
- From $50 an hour
- Part-time
- Remote
- Master of Social Work
- Microsoft Excel
- Psychiatry
Quick Apply
Substance Abuse Counselor
Confidential —Durham, NC
- From $50,000 a year
- Full-time
- Addiction Medicine
- Mid-level
- Outpatient experience
- Health insurance
- Dental insurance
Quick Apply
Clinical Director
Red Oak Recovery Center —Durham, NC
- $90,000 - $100,000 a year
- Full-time
- LMFT
- CPR Certification
- Addiction Medicine
- Loan repayment program
- Health insurance
Board Certified Behavior Analyst (BCBA)
Cardinal Pediatric Therapies —Cary, NC
- $75,000 - $90,000 a year
- Part-time
- Background check
- CPR Certification
- BLS Certification
- Continuing education credits
- Paid holidays
Quick Apply
5d
Board Certified Behavior Analyst (BCBA)
Cardinal Pediatric Therapies —Clayton, NC
- $75,000 - $90,000 a year
- Part-time
- Background check
- CPR Certification
- BLS Certification
- Continuing education credits
- Paid holidays
Quick Apply
7d
Supervisor Clinical Nurse IV - Acute Care Orthopaedics
UNC Health —Raleigh, NC
- $38.51 - $58.82 an hour
- Full-time
- Acute care
- Nursing
- RN License
- Relocation assistance
- Loan forgiveness
Physician Clinic Medical Director
Concentra —Raleigh, NC
- Full-time
- Medicine
- BC/BE
- Clinic
Physician Clinic Medical Director
Concentra —Raleigh, NC
- Part-time
- Medicine
- BC/BE
- Clinic
Board Certified Behavior Analyst (BCBA)
Cardinal Pediatric Therapies —North Carolina
- $75,000 - $90,000 a year
- Part-time
- Background check
- CPR Certification
- BLS Certification
- Continuing education credits
- Paid holidays
Quick Apply
Licensed Mental Health Counselor
Lavni Inc —North Carolina
- From $50 an hour
- Part-time
- Remote
- Master of Social Work
- Microsoft Excel
- Psychiatry
Quick Apply

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Clinical Quality Analyst (Full-time Remote, North Carolina Based)

Alliance Health -
Morrisville, NC

Apply Now

Job Details

Full-time
$79,425 - $101,267 a year

Benefits

Disability insurance
Health insurance
Dental insurance
Paid time off
Vision insurance
Flexible schedule
Retirement plan

Qualifications

Patients with traumatic brain injuries
Clinical case management
Care plan development
Negotiation

Full Job Description

The Clinical Quality Analyst manages the quality review process for care management programs. Incumbents conduct quality reviews of internal data and processes to identify trends/patterns that impact service/system quality and may require interventions.

This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for onsite meetings to the Home office may be required.

Responsibilities & Duties

Analyze Care Management documentation and activities to ensure compliance

Review the quality-of-Care Management internal processes/plans and provider information, such as Person-Centered Plans or chart notes, for alignment with procedures and/or best practices
Audit Care Management clinical documentation, case interventions, and, if available, staff phone recordings to ensure alignment with program descriptions, workflows, internal policies, evidence based clinical guidelines, NCQA guidelines, CMS guidelines, and regulatory guidelines (when applicable)
Identify and escalate situations which may pose quality, compliance, and safety risks that may adversely affect business operation
Evaluate clinical appropriateness of decisions, recommendations, and actions within Care Management documentation
Interpret qualitative and quantitative information to appropriately document findings
Make recommendations for improvement related to any records reviewed and write reports of findings
Identify system and/or operational issues hindering the attainment of quality performance standards as defined by NCQA standards, applicable state and Federal laws and regulations

Analyze Data and Report on findings

Generate monthly Care Management Quality reports on Staff performance to submit to Directors, Managers, and Supervisors
Provide written feedback to Directors, Managers and Supervisors concerning quality concerns pertaining to individual performance, compliance risks/trends, root cause analysis and any system or process improvements recommended

Evaluate knowledge gaps of staff and coordinate training

Evaluate knowledge gaps of the staff and collaborate with Care Management Leadership to coordinate learning and training opportunities with the Care Management Training team
Monitor training of staff for effectiveness and impact of outcomes from enhanced training

Minimum Requirements

Graduation from an accredited school of Nursing with a Registered Nurse (RN) license and three (3) years of experience providing care management to individuals in the following populations; Traumatic Brain Injuries (TBI), Intellectual/Developmental Disabilities (I/DD), Mental Health/Substance Use Disorders (MH/SUD), Severe Mental Illness (SMI), or Physical Health (PH)

Master’s degree in Health, Psychology, Sociology, Social Work, or another relevant Human Services field from an accredited college/university with a North Carolina Clinical license (LCSW, LCMHC, LMFT, LPA) and three (3) years of experience providing care management to individuals in the following populations; Traumatic Brain Injuries (TBI), Intellectual/Developmental Disabilities (I/DD), Mental Health/Substance Use Disorders (MH/SUD), Severe Mental Illness (SMI), or Physical Health (PH)

Required experience

Experience with Care plans, comprehensive assessments, care management interventions, and service engagement activities
Medicaid Managed Care
Integrated care (behavioral and physical health)

Preferred Experience

Auditing Clinical documentation

Preferred Certification-

Certified Care Manager (CCM)

Special Requirement

Current, active, unrestricted NC clinical license such as RN, LCSW, LMHC, or LMFT to practice as a health professional within the scope of licensure in the state of North Carolina.

Knowledge, Skills, & Abilities

Knowledge of North Carolina State and Federal rules and requirements related to the service continuum in North Carolina
Knowledge of Tailored Plan, Integrated Care and Care Management processes and regulatory requirements
Knowledge of best and promising practices for behavioral & physical health and/or intellectual/developmental disabilities
Microsoft Excel, Word, PowerPoint, SPSS, and Survey Monkey (or other online survey tool)
Strong clinical skills
Problem solving skills
Interpersonal Skills
Strong Analytical skills
Problem solving and conflict resolution skills
Strong diplomacy skills and discretion
Highly effective communication skills
Ability to negotiate and resolve issues with minimal assistance

Salary Range

$79,425 - $101,267/ Annually

Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.

An excellent fringe benefit package accompanies the salary, which includes:

Medical, Dental, Vision, Life, Long Term Disability
Generous retirement savings plan
Flexible work schedules including hybrid/remote options
Paid time off including vacation, sick leave, holiday, management leave
Dress flexibility

Want to learn more about what it's like work as part of the Care Management Team? Click on our video to learn more: https://youtu.be/1GZOBFx61QU (https://youtu.be/1GZOBFx61QU)

Education

Preferred

Nursing or better in Nursing
Masters or better in Human Services

Licenses & Certifications

Preferred

Lic Clinical MH Counselor
Lic Clinical Social Wkr
Lic Marr & Family Ther
Lic Psychological Assoc
Registered Nurse

Skills

Required

Analysis
Diplomacy
Microsoft Office

Preferred

Problem Solving

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.

Apply Now

Refine Your Search

director of case management jobs in raleigh nc

Clinical Quality Analyst (Full-time Remote, North Carolina Based)

Senior Director of Reentry

Care Management Consultant (Full-time Remote, NC Based)

Social Worker III - Continuous Quality Improvement Trainer

Social Worker III - Continuous Quality Improvement: Quality Assurance Adult Services

Income Maintenance Supervisor III - Medicaid Program Manager

Board Certified Behavior Analyst (BCBA) - Hybrid

Board Certified Behavior Analyst (BCBA) - Center Based

Board Certified Behavior Analyst (BCBA) - Hybrid

Senior Lead Board Certified Behavior Analyst (BCBA)

Licensed Mental Health Counselor

Substance Abuse Counselor

Clinical Director

Board Certified Behavior Analyst (BCBA)

Board Certified Behavior Analyst (BCBA)

Supervisor Clinical Nurse IV - Acute Care Orthopaedics

Physician Clinic Medical Director

Physician Clinic Medical Director

Board Certified Behavior Analyst (BCBA)

Licensed Mental Health Counselor

I want to receive the latest job alert for director of case management in raleigh nc

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