New Hanover & Brunswick Area

RHA Health Services•Wilmington, NC

About The Position

RHA Health Services is hiring a CAP Case Manager to provide case management services to beneficiaries at risk of institutionalization. The role supports their health, safety, and well-being through person-centered care planning and coordination of essential services. The Case Manager works with beneficiaries, families, registered nurses, and interdisciplinary team members to assess needs, coordinate care, and provide ongoing support to help beneficiaries achieve the best possible quality of life. The position serves the New Hanover and Brunswick area and is listed as part-time with flexible hours. The rate of pay is $22.00 per hour. It has no supervisory responsibilities. Candidates must meet one of the listed education and experience pathways in social work, human services, another field, or nursing. An NC Medicaid-certified training program must be completed within 90 calendar days of employment. Candidates who have the required degree or nursing license but lack the required years of experience may be designated as apprentices, with direct supervision and approval of CAP/C workflow documentation and tasks by the case management supervisor. The physical demands include lifting at least 10 pounds, pulling at least 20 pounds, squatting, kneeling, crawling, crouching, climbing, stooping, and regularly standing and walking. Pre-employment screening includes criminal background and registry checks, drug testing, education verification, and other credentialing based on position requirements. For positions requiring transportation of individuals, proof of a driver's license, insurance, and vehicle may be required. RHA Health Services provides services in North Carolina, Georgia, Pennsylvania, Tennessee, and New Jersey. The organization describes its mission as providing a safe and healthy environment and creating opportunities for personal outcomes for people with intellectual and developmental disabilities and mental health or substance use needs.

Requirements

Strong understanding of Medicaid programs and compliance requirements.
Excellent communication and interpersonal skills for working with families and multidisciplinary teams.
Ability to manage multiple priorities and maintain detailed records.
Experience working with medically fragile children or in pediatric healthcare settings and physically disabled adults with complex care needs.
Social work pathway: bachelor's degree in social work from an accredited school of social work and at least one year of directly related community experience, preferably case management in health or medical settings such as homecare, long-term care, or personal care.
Human services pathway: bachelor's degree in a human services or equivalent field from an accredited college or university and at least two years of community experience, preferably case management in health or medical settings such as homecare, long-term care, or personal care.
Non-human services pathway: bachelor's degree in a non-human services field and at least two years of related community experience, preferably case management in health or medical settings such as homecare, long-term care, or personal care.
Nursing pathway: current North Carolina Registered Nurse license with a two-year or four-year degree and at least one year of case management experience in homecare, long-term care, or personal care.
Complete an NC Medicaid-certified training program within 90 calendar days of employment.
Meet the stated physical demands, including lifting at least 10 pounds, pulling at least 20 pounds, squatting, kneeling, crawling, crouching, climbing, stooping, and regularly standing and walking.
Complete pre-employment screening, including criminal background and registry checks, drug testing, education verification, and position-related credentialing.

Responsibilities

Conduct initial pre-screenings and assessments of beneficiaries and families across medical, psychological, behavioral, financial, social, cultural, environmental, legal, vocational, educational, and other areas.
Educate beneficiaries and primary caregivers about waiver services, Medicaid, and community resources.
Identify needs and risks that may affect health, safety, or continued community placement.
Develop and maintain individualized, person-centered care plans, including emergency and disaster plans; review them at least annually or when beneficiary circumstances change.
Help beneficiaries and families understand care plans and make informed choices.
Link beneficiaries and families to services, equipment, and supplies needed to support care at home.
Collaborate with community resources, healthcare providers, and agencies; initiate referrals and coordinate services.
Monitor services through monthly phone calls and home visits, documenting observations and beneficiary progress.
Evaluate care-plan effectiveness and recommend or implement changes to achieve desired outcomes.
Maintain accurate, current case management documentation in accordance with state and agency guidelines.
Provide emotional support and basic counseling to beneficiaries and families, including assistance with palliative care, behavioral issues, and medical needs.
Obtain medical documentation confirming the need for specific CAP services and maintain beneficiary medical records, including current status, service changes, and referrals.
Comply with 10A NCAC 27G.0202, other regulatory guidelines, agency policy, and the State CAP manual; complete required records, including discharge summaries.
Review billing codes and compliance for case management, in-home aide documentation, paid live-in caregivers, recertifications, and supply billing.
Complete NC Medicaid-certified training within 90 days of employment and maintain program compliance.
Work with RNs and interdisciplinary team members, participate in case discussions, and contribute to quality care and service delivery.
Advocate for beneficiaries and families, secure resources and services, and act as a liaison with external providers.
Train and support families to help them manage their child's care.
Complete state-mandated training and agency-required continuing education annually; stay current on CAP guidelines and best practices.
Update the CAP Business system and other documentation systems as required.
Perform other duties as assigned.

Benefits

Payactiv early access to wages already earned before payday.
Employee perks and discount program.
Paid time off for full-time employees only.
Health insurance for full-time employees only.
401(k) retirement savings program.
Wellbeing programs focused on physical, emotional, and financial wellness.
Chronic disease management programs for hypertension and diabetes for qualifying employees.
Free CPR, first aid, and job-specific training opportunities.

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