Care Management Professional (4235)
About The Position
Carolina Outreach is seeking a Care Manager to proactively engage with high-risk members, particularly those with behavioral health challenges, and support their whole-person health. The role involves assessing, evaluating, and coordinating members’ physical, behavioral, and support needs to identify and resolve barriers to effective care. Responsibilities include developing/updating Individualized Service Plans, managing medications, providing self-management tools, and facilitating communication between various providers. The candidate must be comfortable managing a high volume of calls, demonstrating strong assertive engagement skills, and connecting with hard-to-reach members. Experience in a performance-driven environment with established productivity standards and quality metrics is essential. The Care Manager will monitor members for clinical changes, evaluate findings, assist in developing Individualized Service Plans, coordinate care with primary care providers and other health providers, and provide or facilitate resources and referrals. This role is crucial in ensuring all treating providers are updated with the latest information. This description outlines the general scope and level of work for this role and is not intended to include every duty or responsibility.
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
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)
Benefits
- 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
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
