Care Manager

Community Care of North Carolina Inc•Cary, NC

11d•Hybrid

About The Position

Community Care of North Carolina (CCNC) is transforming healthcare by utilizing statewide data and predictive analytics. Community-based care-managers collaborate with local physicians and diverse health professional teams to create comprehensive care plans. These plans connect individuals to local resources, aiming to improve equity and access to high-quality care across North Carolina. The Care Manager's role is to address the needs of the served population by assessing, planning, implementing, coordinating, monitoring, and evaluating required services and options. This involves utilizing communication and available resources to promote quality, cost-effective health outcomes. The Care Manager will operate within the scope of practice for a Registered Nurse and/or Licensed Clinical Social Worker, working in partnership with the Primary Care Provider, member, guardian, caregivers, family members, other Care Management Team members, and the community to coordinate a full spectrum of healthcare services. The position requires consideration of the member's holistic needs, including their unique social and cultural dynamics. The Care Manager may work remotely within designated regions to support needs across the state, serving populations within regions 2, 4, and 6. Remote work and travel within the region and/or the State are required. Residency in Davie, Davidson, or Iredell Counties is preferred.

Requirements

Graduation from an accredited school of nursing
Active, unrestricted RN license to practice in North Carolina
Minimum 2 years’ nursing experience
Master’s degree from an accredited school of social work
Minimum 2 years’ social work experience
Active NC license as a Licensed Clinical Social Worker (LCSW)
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
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
1-year case management or community-based social work 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
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.
Facilitate referrals for members/families to appropriate community-based services and agencies as per guidance.
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.