TCL Diversion Clinician (Full-time Remote, Morrisville, NC Based)

The TCL Diversion Clinician is responsible for reviewing and interpreting documentation for continued TCL eligibility.  Clinician will also be responsible for making appropriate clinical recommendations and/or referrals as clinically necessary.

This position will allow the successful candidate to work a primarily remote schedule. They will be required to work onsite to the Alliance Morrisville, NC office (Wake, Cumberland, Johnston County Office), whichever, is closest to their residential location. Must be willing to travel to meetings within the communities Alliance serves as needed.

Responsibilities & Duties

Provide Care Team Support

• 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


• Support members transitioning from institutional care settings to community-based care


• Will function in an episodic and consultative manner by providing subject matter expertise, within scope, regarding member’s physical and/or behavioral health to support the development and delivery of a whole person approach to the treatment team

Complete Assessments and Planning

• Utilize person-centered planning, motivational interviewing and assessments to gather information


• Review clinical documentation for members that are medically fragile or have significant health conditions, have a mental health condition, substance use condition, or co-occurring intellectual or developmental disability 


• 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 


• Provide education to community stakeholders and providers on TCL eligibility and processes


• Educate team members about impact of member’s health conditions on service engagement, clinical outcomes, and prognosis for change


• Actively collaborate with member and care team members (providers, community stakeholders, natural supports) to ensure care plan accurately reflects the individual’s clinical needs and desired life goals 


• Provide technical assistance to providers in developing an integrated person centered plan


• Collaborate with medical staff in reviewing member’s medical history and identify specific goals and types of activities that will be used to help members work towards those specific goals

Monitoring/Coordination

• Appropriately 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 transition activities on behalf of the member


• Timely coordination amongst internal and external stakeholders to increase efficient response and movement towards transition efforts


• Reports care quality concerns to Quality Management as needed

Documentation

• Ensure all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency, and Medicaid requirements 


• Ensure timely completion of all TCL data into state and internal required platforms


• Follow administrative procedures and effectively manage caseload

Data

• Utilize data to analyze needs of the members we serve, guide staff training development, identify resource needs and consistency of workflow implementation across disciplines

Minimum Requirements

Education & Experience

Master’s degree in Human Services or related field and at least two years of full-time, post graduate degree, MH/SUD and or Intellectual/Developmental Disabilities (I/DD) experience and active, valid NC clinical license

Required License: LCSW, LCMHC, LPA, or LMFT

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

$66,227 - $88,695/ 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