The Supervisor II-Transition Support Specialist is a licensed healthcare professional who oversees the timely and effective transitions of care between Alliance Health Plan and other health plans or Provider Led Entities. Working as part of the multidisciplinary care team (MCT), this role ensures TST provides episodic support including warm handoffs, state-required assessments, reporting, and coordination of follow-up care.

Key responsibilities include managing transition-related data, responding to inquiries (e.g., transition dates, Tailored Care Management status, episode accuracy), and ensuring accurate referrals to appropriate clinical services. This supervisor communicates and collaborates with internal Care Management teams and leadership, Provider Led Entities, other Alliance departments, and external stakeholders to resolve transition barriers. They are accountable for maintaining an effective and efficient team workflow and reporting requirements to Alliance leadership and the state.

This position is full-time remote opportunity. There is no expectation of coming into the office routinely, however, the selected candidate must be available to report onsite to the Alliance Office (Morrisville, North Carolina) for business meetings as needed.

Responsibilities & Duties

Supervise and Develop Staff Work with Human Resources and Unit Manager to maintain and retain a highly qualified and well-trained workforce
Ensure staff are well trained in and comply with all organization and department policies, procedures, business processes, and workflows for care managers working with BH/IDD/TBI and/or 1915i services
Ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements
Actively establish and promote a positive, diverse, and inclusive working environment that builds trust
Ensure all staff are treated with respect and dignity
Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members
Work to resolve conflicts and disputes, ensuring that all participants are given a voice
Set goals for performance and deadlines in line with organizational goals, departmental strategic goals and the organization's vision and values
Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional growth and development
Cultivate and encourage efforts to expand cross-team/ departmental collaboration and partnerships

Supervise Unit Operations

Coordinate with internal teams and external partners to ensure timely, informed, and seamless care transitions. This includes internal CM, Practice Transformation, PLEs, all Standard Plans, Healthy Blue Caring Together, Local Health Departments, and other LME/MCOs
Manage inbound and outbound communications related to transition planning, data accuracy, and care coordination. This includes oversight of the TST email box, triaging requests to TST, CM leadership, Practice Transformation and other departments as identified
Ensure that transition data is pulled, analyzed, and interpreted to identify needs, assign follow-up tasks, and support care planning. This requires accessing data from multiple reports, validating accuracy, and synthesizing data into an integrated report
Proactively identify and resolve transition-related issues to minimize care gaps and enhance member outcomes. This will involve, but not limited to, recognizing potential concerns revealed in data pulls, requests/notifications via the TST mailbox, and alerts from internal departments or external stakeholders
Ensure that staff activities are properly and professionally documented based on current documentation requirements within electronic medical record platform as well as internal and external email communication
Provide administrative oversight for team, identifying when escalation is necessary or when collaboration is warranted and offering supervision on complex cases
Participate in all related management and clinical team meetings as required

Support Continuous Quality Improvement

Develop and/or assist in the development of policies, procedures, and workflows pertaining to the implementation and sustainability of the Tailored Plan and member transitions as directed by contract, regulation, and accreditation
Make recommendations to improve department procedures and increase operational efficiency
Monitor trends and identify opportunities for enhancements in member transitions, service utilization and implementation throughout Alliance

Assure Compliance with Alliance Policies and Procedures

Adhere to all Alliance Organizational Policies and Procedures and Care Management Desk Procedures
Ensure team adherence to agency and departmental policies and procedures to facilitate the functioning of the team and compliance with agency, state and federal regulations

Travel

Travel between Alliance offices, attending meetings on behalf of Alliance, participating in Alliance sponsored events, etc. is required
Travel to meet with members, providers, stakeholders, attend court hearings etc. may be required

Minimum Requirements

Education & Experience

Required:

Graduation from an accredited school of nursing with Registered Nurse license and five (5) years of experience with at least two (2) years of applicable experience with the population served, including experience with case management/discharge planning in one of the following settings: Acute care, Home care, LTC care, Physician Office or Managed Care

Or

Master's degree in Human Services from an accredited college or university and three (3) years post graduate degree experience with at least two years of applicable experience with the population served, including experience with case management/discharge planning in one of the following settings: Acute care, Home care, LTC care, Physician Office or Managed Care.

Must have a valid, active clinical license as a LCSW, LMFT, LCAS, LCMHC, LPA, or RN in North Carolina.

North Carolina residency required.

Preferred:

Experience supervising direct reports and background in managed care, population health management, and data management preferred.

Knowledge, Skills, & Abilities

People management
A high level of diplomacy and discretion is required
Problem solving, negotiation, arbitration and conflict resolution skills
Must be highly skilled at shifting between macro and micro level planning
Detail oriented
Ability to organize multiple tasks and priorities, and to effectively manage projects from start to finish.
Ability to quickly adapt to mandated changes and priorities within the department.
The ability to change the focus of his/her activities to meet changing priorities.
Proficiency in Microsoft Office products (such as Word, Excel, Outlook, PowerPoint, etc.) is required
Proficiency in pulling and analyzing data to generate reports
Knowledge of resources and systems in the community that can assist with eliminating SDOH barriers to treatment and whole person living.
Building and sustaining teams

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

Employment for this position is contingent upon a satisfactory background and MVR (Motor Vehicle Registration) check, which will be performed after acceptance of an offer of employment and prior to the employee's start date.

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Supv II-Transition Support Specialist (Remote, North Carolina Base)