Hybrid Care Manager 1 – Non Clinical

at Community Care of North Carolina

• Job title: Care Manager 1 – Non Clinical
• Job type: Full Time
• Experience level: Junior, Mid level
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Cary, United States

About the role

• Care Manager providing statewide care management to support Medicaid enrolled members in North Carolina. Collaborating with healthcare professionals to promote quality care outcomes.

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