Program Manager, Specialized Consultative Services

Covenant Case Management Services is seeking a high-energy SCS Program Manager.

The SCS Program Manager oversees licensed practitioners providing clinical support to individuals with intellectual/developmental disabilities on the North Carolina Innovations Waiver or "Registry of Unmet Needs." They are part of the Senior Management team, responsible for all aspects of service provision with Clinical development Directors' support.

What You Will Do | Responsibilities

Compliance:

• Maintain comprehensive knowledge of clinical compliance requirements related to Medicaid and state regulations, ensuring all clinical documentation and practices adhere to standards.
• Facilitate communication and training on compliance obligations across the organization.
• Conduct compliance audits and oversee the documentation process to fulfill reporting obligations.
• Participate in all MCO and State reviews of programs, when necessary.
• Participate in interagency meetings, provider meetings, and other MCO.
• Maintaining all required certifications and documentation.
• Ensuring that all supervisions are conducted with clinicians along with submitted to HR.
• Review all incident reports and submit them to the Quality management director.
• Completing Tar’s in a timely manner to ensure families are supported.
• Ensure authorizations are secured in a timely manner to maintain on-
• going SCS service provisions.
• Ensure SCS-LPs are completing annual packets with member/guardians
• and providing summary progress reports for ISP team members.

Clinical Policies & Procedures:

• Monitor and develop clinical policies and practices to align with compliance requirements and promote a workplace culture of diversity, equity, and inclusion.
• Oversee the creation and compliance of all clinical policies, ensuring supporting documentation is readily available.
• Serve as the primary contact for clinical policy and compliance inquiries.
• Providing support to all clinicians to ensure that they are adhering to compliance of company policies and procedures.

Program Development:

• Collaborate with the Quality Management Director to develop, implement, and review clinical protocols and programs.
• Ensure clinical expertise is integrated at all organizational levels, enhancing service delivery and operational efficiency.

Stakeholder Engagement:

• Cultivate relationships with Managed Care Organizations (MCO), state representatives, and community stakeholders to ensure compliance and foster collaboration in the SCS Capacity
• Attend relevant community and state training sessions to stay informed on regulatory changes and best practices.

Operational Oversight:

• Supervise Regional Directors and Program Managers, providing clinical support and guidance for various self-sustaining programs (SCS, Nursing Respite, IFDS, Day Services, and Peer Support).
• Assist in the management of service enrollment and contracts with MCOs, ensuring continuity of care.
• Manager will be responsible for ensuring someone is working during
• the time needed, if still in the process of searching for staff).
• Submit staff meeting notes and supervision forms to HR.
• The manager is responsible for providing oversight to all SCS clinicians and ensuring they are working efficiently.
• Maintain the SCS budget for any MCO that has cap set on contract with
• support of CHIEF FINANCIAL OFFICER (CFO).
• Tracking authorizations and units billed for SCS-Funded services.

Quality Assurance and Improvement:

• Review and approve incident reports, complaints, and grievances, submitting findings to the Quality Management Director.
• Collaborate with the Quality Management Director to prepare for accreditation surveys and post-payment reviews, delegating tasks as necessary.
• The individual will maintain close communication with families when seeking staff for their loved one's care or support, especially in urgent or crisis situations.
• Supervise and guide SCS-Licensed and Board-Certified Practitioners/Contractors in coordinating and providing quality assessments, evaluations, plans, monitoring, and crisis services across all regions.

Data Analysis and Reporting:

• Oversee performance indicators to analyze data, identify trends, and propose improvements to workflows and services.
• Ensure timely completion of organizational plans and reports.
• Responsible for scheduling employees/contractors training as well as monitoring due dates.

Advocacy and Ethical Oversight:

• Actively participate in the Human Rights Committee to advocate for client rights and ensure ethical practices within the organization.
• Expand knowledge of Tailored Plans and ensure readiness for implementation changes.

Additional Duties:

• Operate under the direct supervision of the Chief Operations Officer, undertaking other duties as assigned to support the organization’s mission.

What We Are Looking For | Qualifications

• Proven ability to communicate and implement a shared organizational vision, motivating staff toward common goals.
• Strong organizational skills with the ability to manage multiple clinical tasks efficiently and effectively.
• Exceptional communication and interpersonal skills, fostering collaboration across multidisciplinary teams.
• Ability to maintain composure and effectiveness under stress.
• Excellent analytical and decision-making skills, with a focus on operational and programmatic efficiency.
• Familiarity with Medicaid requirements, Clinical Coverage Policies, and individual charting/medical record requirements.

What We Are Looking For | Education & Licenses

• Advanced degree in a health-related field (e.g., Psychology, Counseling, Nursing) required.
• Licensure preferred but not required.
• Supervisory: 2 years’ experience
• Management: 2 years’ experience

Location | Travel

• Hybrid work environment with on-site requirements.

Covenant Rewards for You | Benefits

• Generous Total Rewards Plan – including health insurance, 401k match, and career benefits
• Diverse and inclusive community focused on growth, compassionate care, and a supportive work environment