Clinical Consultant Nurse-TCL (Hybrid, North Carolina Based)

We are currently seeking Clinical Consultant Nurse-TCL to serve members in Cumberland, Wake, Durham, and Johnston counties.  The hire may be asked to complete reviews for all catchment areas. 

This position will allow the successful candidate to work a schedule which will include both onsite as well as remote work 4 days of the week as approved by their supervisor. This position will require travel within the communities Alliance serves as needed

The Transition to Community Living RN provides clinical recommendations in an episodic and consultative manner and provides oversight as part of the member’s multidisciplinary care team (MCT) when member physical and/or behavioral health needs are identified and warrant subject matter expertise, or the member is transitioning from facility-based care. 

This position offers clinical and medical recommendations, completes medical data reviews (MDR), provides education within their scope of licensure, and escalates review of complex cases to the Chief Medical Officer, Deputy Chief Medical Officer, Associate Medical Directors, and/or Pharmacists as necessary to optimize health outcomes for the member.

Distinguished from the Complex Care Consultant by the lower level of clinical complexity in cases.

Responsibilities & Duties

Provide Care Team Support

• Support members transitioning from institutional care settings to community-based care
• Provide subject matter expertise, within scope, regarding member’s physical and/or behavioral health to support the development and delivery of a whole person approach 
• Work collaboratively with other Alliance staff, behavioral health providers, primary care physicians, specialty care providers and other community partners and stakeholders to support members in their home communities

Complete Assessments and Planning

• Utilize person-centered planning, motivational interviewing and assessments to gather information 
• Perform medical data reviews and support for members who are medically fragile or have significant health conditions, have a mental health condition, substance use condition, or co-occurring intellectual or developmental disability
• In the Transition and Housing setting, staff will also assess and record member’s activities and progress
• Provide education and supports to members and/or legal guardians regarding self-care strategies, their rights and responsibilities, available treatment options, provider network availability and payor requirements that may impact service access or maintenance 
• Educate team members about impact of member’s health conditions on service engagement, clinical outcomes, and prognosis for change
• Collaborate with member and care team members to ensure care plan accurately reflects the individual’s clinical needs and desired life goals 
• Provide education about advanced directives, preferred natural support and physical health contacts whom the member identifies, and preferred crisis facilities
• Provide medication reconciliation and education 
• Develop and update plans of care based off the needs identified in the assessments and complete the interventions identified as needed
• Review member’s medical history and identify specific goals and types of activities that will be used to help member work to help work towards those specific goals. 
• Work with the member’s multidisciplinary care team to identify gaps in services and intervene to ensure that the member is receiving the appropriate level of care

Monitor and Coordinate Care

• Escalate high risk/high visibility and/or complex barriers/needs members who may have difficulty transitioning out of the facility in a timely manner to supervisors. High risk can involve Health and Safety of a member, staff, or organizational risk 
• Review cases with clinical complexity with direct supervisor, peer clinical review cohort, and utilization management care managers and medical management leadership as needed
• Obtain information releases that will improve care management activities on behalf of the member
• Reports care quality concerns to Quality Management as needed 

Maintain Documentation

• Ensure all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency, and Medicaid requirements 
• Follow administrative procedures and effectively manage caseload

Review Data

• Review, validate and interpret risk stratification data and population health groups and recommend changes or adjustments to care management approach as needed
• Utilize data to analyze needs of the members we serve, guide staff training development, identify resource needs and consistency of workflow implementation across disciplines

Travel 

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

Minimum Requirements

Education & Experience

Graduation from a school of nursing and two years of full-time nursing experience and active NC or Compact Registered Nurse License

Preferred Requirement 

Bachelors Degree in nursing preferred. Home & Community Based Services with the desired population 

Knowledge, Skills, & Abilities

• A demonstrated Knowledge of the assessment and treatment of mental health, substance abuse, intellectual and developmental disabilities
• Knowledge of legal, waiver, accreditation standards and program practices/requirements 
• Knowledge of the Alliance Health service benefit plans and network providers
• Person Centered Thinking/planning
• The employee must be detail oriented
• Ability to independently organize multiple tasks, priorities, and to effectively manage an assigned caseload under pressure of deadlines
• Exceptional interpersonal skills, highly effective communication ability
• Ability to make prompt independent decisions based upon relevant facts and established processes
• Problem solving, negotiation and conflict resolution skills 
• Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) is required

Salary Range

$58,967.33 to $101,510.73/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, Short and Long and Short 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

Education

Required

• Associates or better in Nursing

Licenses & Certifications

Required

• Registered Nurse

Skills

Required

• Collecting information
• Communication
• Consulting
• Critical Thinking
• Documentation
• Microsoft Office