Care Management Professional (4232)

ncgCARE • Raleigh, NC

3d • Hybrid

About The Position

Carolina Outreach is seeking a Care Management Professional to proactively engage with high-risk members, particularly those with behavioral health challenges, and support their whole-person health. This role involves assessing, evaluating, and coordinating members’ physical, behavioral, and support needs to identify and resolve barriers to effective care. The Care Manager will develop and update Individualized Service Plans, manage medications, and provide self-management tools. This position requires facilitating communication between various providers, managing a high volume of member calls, demonstrating strong assertive engagement skills, and working in a performance-driven environment with established productivity standards and quality metrics. The role includes monitoring members for clinical changes, evaluating findings, assisting with Individualized Service Plans, coordinating care with primary care providers and other health providers, providing or facilitating resources, making referrals, and ensuring all treating providers are updated with relevant information. This description outlines the general scope and level of work for this role and is not intended to include every duty or responsibility that may be required.

Requirements

• A bachelor’s degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human service area, or licensure as a registered nurse (RN)
• Minimum experience 5 years of clinical practice in or administration of EBP
• Two years of experience working directly with individuals with behavioral health conditions
• Comfortable in a fast paced evolving climate
• Experience managing large caseload of high need members
• Experience with metric and performance monitor for demonstration of engagement and service
• Upon hire, completion of general onboarding training
• Within 60 days of hire, completion of NC DHHS identified training requirements for Tailored Care Management
• No driving infractions in the last 5 years
• Must be authorized to work in the United States

Nice To Haves

• The candidate must be comfortable managing a high volume of outbound and inbound member calls on a daily basis.
• Must demonstrate strong assertive engagement skills, with the ability to effectively connect with hard-to-reach members and build rapport with individuals who have complex needs.
• Display experience working in a performance-driven environment with established weekly and monthly productivity standards, quality metrics, and performance expectations.

Responsibilities

• Maintain accurate and timely clinical documentation
• Collaborate with care teams as needed
• Maintain compliance with all clinical and regulatory standards
• Participate in supervision (if applicable based on licensure level)
• Monitor members (in person and by telephone) for changes in clinical symptoms and treatment side effects or complications
• Evaluate findings and assist members/families in developing an Individualized Service Plan (ISP) with appropriate goals
• Support and closely coordinate whole-person health care with the member’s primary care provider and other treating health providers
• Provide or facilitate resources internally or in the community for members/families, and make referrals and provide follow-up as appropriate (e.g., social services such as housing assistance, vocational rehabilitation, substance use treatment)
• Ensure all treating providers involved in the member’s care are up to date on the latest test results and information

Benefits

• Competitive hourly pay aligned with your role, experience, and contribution, with opportunities for growth over time.
• Supportive clinical and operational leadership
• Opportunities to build your preferred clinical focus areas
• Streamlined onboarding and credentialing support
• Consumer-driven health plan coverage provided by Anthem
• Wellness: When you enroll in a medical plan, you get complete care support on your time through Sydney app (Anthem), with exclusive access to 24/7 access to licensed doctors, therapists, and psychiatrists.
• Health Savings Account (HSA) or Flex Spending Account (FSA)
• Two dental plan options available through Delta Dental
• Affordable vision plan available through EyeMed
• An optional Dependent Care Flexible Spending Account to reimburse yourself on a pre-tax basis for childcare.
• Generous paid time off
• 401k or Roth IRA Retirement Programs administered by Empower
• Financial planning and education services at no cost to you
• Voluntary supplemental benefits (Accident, Critical Illness, Short-Term Disability)
• Educational Assistance (your position, date of hire and years of service determine your eligibility)
• Licensure Residency Program for Full-time Clinical Staff
• Advancement and Career Development Opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level