Location:
Must reside in North Carolina
Summary:
Care Managers play a vital role in ensuring members receive whole person-centered care to meet their complex physical, mental health, and social needs. The Care Manager engages with members and their caregivers/legal guardians to conduct comprehensive assessments, develop individualized care plans, and coordinate care and other supports. Serving as the single point of contact, the Care Manager works closely with a multidisciplinary team to promote continuity of care and quality outcomes for each member.
Essential Functions:
· - Serve as the primary point of contact for the member, providers, and guardians, overseeing Tailored Care Management activities.
· - Conduct comprehensive assessments to evaluate members' needs and the effectiveness of care.
· - Initiate and continue integrated care plans that encompass physical health, mental health, social supports, and lifestyle.
· - Facilitate multidisciplinary team meetings to ensure cohesive service delivery and member engagement in care management.
· - Manage medication oversight and utilize medication management assessments as part of care plans.
· - Facilitate care transitions to prevent adverse outcomes and readmissions.
· - Refer members to community-based resources and assist them in selecting providers and care teams.
· - Ensure compliance with internal and external regulatory requirements, including HIPAA and Medicaid guidelines.
Knowledge, Skills, and Abilities:
· - Deep understanding of holistic, whole-person care and Tailored Care Management.
· - Strong interpersonal skills with the ability to build trust and rapport with members.
· - Knowledge of chronic health condition management and behavioral health crisis protocols.
· - Proficiency in Microsoft Office and electronic health records systems.
· - Excellent communication, negotiation, and documentation skills.
Decision Making/Consequences of Error:
Responsible for making independent decisions in care management. Ensures accurate documentation and compliance with healthcare regulations to avoid critical errors that could impact member care and program success.
Minimum Education:
Associate’s degree in Nursing (RN only). Bachelor’s or Master’s degree based on required experience in health, psychology, sociology, social work, nursing, or another relevant human services field.
Minimum Experience:
Must meet the Qualified Professional status with extensive experience in MH/DD/SA care. Experience in coordinating Long Term Services and Support (LTSS) and Home and Community Based Services (HCBS) is highly desirable.
Professional License or Certification Required/Preferred:
Fully licensed by the NC governing board regulating Human Services professions; or Fully licensed RN by the NC Board of Nursing with required experience. Additional certifications related to health care management preferred.
Other Position Characteristics:
A valid active driver's license is required. Residence within the region being recruited, or within 25 miles of the desired region.
Job Types: Full-time, Contract
Pay: From $50.00 per hour
Expected hours: 40 per week
Benefits:
Schedule:
- 8 hour shift
- Monday to Friday
Experience:
- Nursing: 1 year (Required)
- Case management: 2 years (Required)
License/Certification:
Location:
- North Carolina (Required)
Work Location: Remote
