Care Manager

Community Care of North Carolina•Greenville, NC

1d•Hybrid

About The Position

Community Care of North Carolina (CCNC) is dedicated to transforming healthcare across North Carolina by connecting people to the right local resources and increasing equity and access to high-quality care. Our community-based care managers work with local physicians and diverse teams of health professionals, informed by statewide data and predictive analytics, to develop whole-person plans of care. Our mission is to improve the health and quality of life for all North Carolinians by building and supporting better community-based healthcare delivery systems. The Position Summary outlines the role of the Care Manager in addressing the needs of the population served by assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required. This role utilizes communication and available resources to promote quality, cost-effective health outcomes. Performing within the Registered Nurse and/or Licensed Clinical Social Work scope of practice, the Care Manager collaborates with the Primary Care Provider, member, guardian, caregivers, family members, other members of the Care Management Team, and the community to coordinate a full continuum of health care services. Holistic needs of the member, inclusive of unique social and cultural dynamics, should be considered. The Care Manager may work remotely within regions to cover the needs across the state, serving populations within regions 2, 4, and 6. Remote work and travel will be required within the region and/or the State. Residing in Pitt, Wilson, Wayne, or Carteret Counties is preferred.

Requirements

Registered Nurse (RN) Graduation from an accredited school of nursing
Active, unrestricted RN license to practice in North Carolina
Minimum 2 years’ nursing experience
1-year care management or community-based nursing preferred
CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements
Meets licensure or educational eligibility requirements as determined by The Commission for Case Management Certification
Access to Hospital/Data or Electronic Medical Record system will be required, as necessary
Maintain a valid driver’s license with current auto liability insurance
Social Worker Master’s degree from an accredited school of social work
Minimum 2 years’ social work experience
1-year case management or community-based social work preferred
Active NC license as a Licensed Clinical Social Worker (LCSW)
CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements
Meets licensure or educational eligibility requirements as determined by The Commission for Case Management Certification
Access to Hospital/Data or Electronic Medical Record system will be required, as necessary
Maintain a valid driver’s license with current auto liability insurance
Computer skills required including various office software and the internet
Excellent communication skills – oral and written
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 a member 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
Able to shift strategy or approach in response to the demands of a situation

Nice To Haves

BSN preferred
experience with MS Office software preferred
Bilingual preferred

Responsibilities

Provide effective Care Management services based on case management standards of practice to enrolled populations.
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 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 member’s values, experience, and help to empower members to be an advocate for their own care.
Maintain appropriate member 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.
Attend departmental and corporate meetings, local and regional training, or other events as required.
Travel using personal vehicle will be required within the region and/or the State.
Perform all other duties as requested.