Manager overseeing integrated system planning across transmission and distribution at Xcel Energy. Leading a team to optimize the processes and tools within the energy sector.
About the role
- Care Manager providing integrated services to Medicaid enrolled members in North Carolina. Role involves assessments, coordination, and collaboration with healthcare providers and community agencies.
Responsibilities
- Provide integrated whole-person Care Management under the new program Care Management model, including coordination across physical health, behavioral health, I/DD, LTSS, pharmacy, and unmet health-related needs
- Complete member assessments considering the total individual, inclusive of medical, biopsychosocial, behavioral, spiritual, and cultural needs to enrolled population, throughout the continuum of care
- Work with members and caregivers to identify and address behavioral, social, cultural, and environmental strengths and barriers as it relates to his/her diagnosis, treatment, and access to care
- Provide education to member/family about clinical diagnosis, medications, available resources, prevention, and risk factors to achieve optimal self-management
- Monitor quality and effectiveness of interventions to the enrolled populations by setting patient-centered SMART goals in collaboration with the members/families
- Develop, review, implement, and evaluate the member care plan in partnership with the member, caregiver/guardian/family members, providers, and Care Management team members, as applicable
- Incorporate therapeutic skills and techniques such as trauma-informed care, motivational interviewing, strengths-based, and solution-focused modalities to help members achieve healing, growth, health, and wellness
- Utilize Hospital/Data or Electronic Medical Record system as available
- Per guidance, facilitate referrals for members/families to appropriate community-based services and agencies
- Refer to appropriate clinical team members for interventions which are outside the Care Managers’ scope of practice and/or expertise
- Work collaboratively with multi-disciplinary team members to facilitate achievement of desired treatment outcomes
- Engage and maintain collaborative relationships with community provider agencies that promote quality care and cost-effective health care utilization
- Serve as a liaison among the member/family/guardian, community services, primary providers, specialists, and other care team members to coordinate services without duplication
- Respect the member’s values, experience, and help to empower members to be an advocate for their own care
- Maintain appropriate documentation in the Care Management documentation platform, in accordance with organizational policies and procedures
- Meet monthly productivity and role expectations
- Understand, uphold, and abide by CCNC company and department policies, goals, standards, and objectives
- Adhere to CCNC privacy, security policies, and HIPAA regulations to ensure that patient and company data are properly safeguarded
- Perform all other duties as requested
- Attend departmental and corporate meetings, local and regional trainings, or other events as required
- Travel using personal vehicle will be required within the assigned area, region and/or the State
Requirements
- Requires a Bachelor's Degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services area or licensure as an RN
- 2 years of experience working directly with individuals served by the child welfare system is preferred
- Must reside in NC or within forty (40) miles of the NC Border
- CCM certification preferred
- Maintain a valid driver’s license with current auto liability insurance
- Computer skills required including various office software and the internet; including experience with MS Office software
- Excellent communication skills – oral and written; Bilingual preferred
- Knowledge of government, private sector, and community resources
- Knowledge of Case Management principles
- Knowledge of, and compliance with, federal and state regulations applicable to the position
- Strong organizational and time management skills
- Skills in establishing rapport with members and caregivers and applying techniques of assessing comprehensive health care needs
- Critical thinking skills, effective clinical judgment, independent decision-making, and problem-solving abilities
- Sensitivity to diversity of cultures, language barriers, health literacy, and educational levels
- Ability to work independently and function as an integral part of a multi-disciplinary team
- Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives
- Ability to shift strategy or approach in response to the demands of a situation
- Ability to navigate Hospital/Data or Electronic Medical Record systems, as necessary
Benefits
- Competitive Benefits Package effective first day of employment
- Tuition reimbursement provided to foster CCNC's culture of learning and knowledge, personal and professional growth
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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