Care Manager I-TCL ( Hybrid- Mecklenburg County, North Carolina Based)

Alliance Health•Durham, NC

12d•$30 - $38•Hybrid

About The Position

The Care Manager I-TCL provides integrated, whole-person care management to individuals and families with special health care needs. The role coordinates physical health, behavioral health, pharmacy, and unmet health-related resource needs to connect members with appropriate services and supports, promote quality care, maximize outcomes, and reduce unnecessary hospital and emergency service use. The Care Manager focuses on a specified population of members who use health care services, ensuring their health needs and referrals are addressed. The position collaborates with community systems and supports members in remaining in their preferred housing in accordance with Transition to Community Living (TCL) requirements. This is a full-time hybrid position. The selected candidate must routinely report onsite to the Alliance Office as needed and travel within Alliance communities throughout Mecklenburg County. Travel to offices, member and provider visits, stakeholder meetings, court hearings, and Alliance-sponsored events may be required. The Care Manager completes assessments and person-centered plans of care; coordinates interventions, referrals, services, and transitions; educates and monitors members and their legally responsible persons; and documents activities in required systems. The role also supports TCL monitoring, tenancy stability and rehousing, housing separations, and community integration. The position must follow organizational policies and procedures, state and agency documentation standards, and Medicaid requirements. Employment is contingent on satisfactory background and motor vehicle record checks after offer acceptance and before the start date.

Requirements

Meet one of the following education and experience pathways: bachelor’s degree in a Human Services field from an accredited college or university and two years of post-bachelor’s mental health/developmental disabilities/substance abuse (mh/dd/sa) experience with the population served; bachelor’s degree in a non-Human Services field and four years of post-bachelor’s mh/dd/sa experience with the population served; master’s degree in a Human Services field and one year of postgraduate mh/dd/sa experience with the population served; full or provisional North Carolina licensure as an LCSW, LCMHC, LPA, or LMFT; or North Carolina Registered Nurse licensure and four years of mh/dd/sa experience with the population served.
Knowledge of person-centered thinking and planning and use of assessments to develop plans of care.
Knowledge of the Diagnostic and Statistical Manual of Mental Disorders.
Knowledge of the level-of-care process, SIS for IDD, and FASN assessment for TBI.
Knowledge of Medicaid Tailored Plan, Medicaid Direct, enhanced MHSUD, and waiver benefits plans.
Knowledge of and skill in motivational interviewing.
Proficiency with Microsoft Office products, such as Word, Excel, and Outlook.
Strong interpersonal and written and verbal communication skills.
Conflict management and resolution skills.
Diplomacy and discretion to negotiate and resolve issues with minimal assistance.
Ability to make prompt, independent decisions based on relevant facts.
Ability to travel as required within Alliance communities and to member, provider, stakeholder, and other locations.
Satisfactory background and motor vehicle record checks are required after offer acceptance and before the start date.

Nice To Haves

NACCM certification.
NADD-Specialist certification.
CBIS certification.

Responsibilities

Complete comprehensive assessments or Care Needs Screenings at enrollment, annually, or when a member’s condition changes, and develop plans of care based on the results.
Coordinate whole-person care and assign plan-of-care interventions to appropriate care management team members, including referrals for medical or pharmaceutical complexity and support for social determinants of health, disparities, or complex payer issues.
Help members or legally responsible persons choose service providers objectively and evaluate whether services are appropriate and plans of care are implemented.
Use person-centered planning, motivational interviewing, and historical assessment information in JIVA to identify member needs and supports.
Collaborate with members, legally responsible persons, care teams, providers, and other supports to develop plans reflecting member needs and life goals, including within the permanent supportive housing model.
Collect information to identify barriers and assess the effectiveness of care management in reducing lengths of stay and emergency service use.
Arrange initial member contact and face-to-face, virtual, or telephone meetings to assess, engage, and educate members about the Alliance Health Plan, care teams, resources, and services.
Educate and support members and legally responsible persons regarding rights, grievances and appeals, service options, available providers, and payer requirements.
Refer members in crisis or institutional settings who need help returning to community services to the Integrated Health Consultant or appropriate care team member.
Recognize and report critical incidents and provider quality concerns to supervisors and the Quality Management Department.
Complete JIVA activities associated with plans of care and coordinate transitions to appropriate levels of care.
Check in with members, verify care needs are met, update plans of care, follow up with stakeholders, and promote customer satisfaction through timely communication.
Monitor service adherence with members, guardians, or providers; identify treatment barriers; and help members arrange appointments or connect with treatment providers.
Maintain required member or legally responsible person contacts under state contractual requirements and attend community, provider, and stakeholder meetings as needed.
Obtain and upload supporting documents, legally responsible person verification, and releases of information; open new JIVA episodes when needed; and document member updates and activities according to organizational procedures.
Escalate complex cases and concerns to the immediate supervisor and share appropriate documentation with stakeholders when consent has been granted.
Maintain medical record compliance and quality in JIVA, Clive, and TCLD, and ensure clinical documentation meets state, agency, and Medicaid standards.
Coordinate planned moves outside the Alliance geographic area and other transitions to prevent lapses in care.
Follow Alliance organizational policies, procedures, and Care Management Desk Procedures.
Complete TCL monitoring to support tenancy, health, safety, community integration, property and provider coordination, technical assistance, service linkage, barrier resolution, monthly tenancy checklist review, and routine reporting.
Assist the Post-Transition Engagement Specialist with contact information so 11-month and 24-month Quality of Life surveys can be completed by their due dates.
Support the Supportive Housing team in securing documents needed to maintain TCL tenancy, including annual inspections, biannual recertification, income adjustments, and monthly housing checklists.
Complete and follow up on voucher applications, provide technical assistance during rehousing, and conduct at least monthly provider follow-up when a member loses TCL housing and requests rehousing.
Assist providers with required documents for members moving to the Bridge or Hotel Program and update state and Alliance Health data systems when rehousing is confirmed.
Educate members about Individual Placement and Support-Supported Employment (IPS-SE), employment referrals, community integration, and education referrals and support.
Complete required discharge tasks when a member leaves TCL housing.
Travel between Alliance offices and to meet members, providers, and stakeholders; attend meetings, court hearings, and Alliance-sponsored events as required.