Tailored Care Management- Care Manager

Noble Hearts HR Consulting•Wilson, NC

10d•$21 - $28

About The Position

The Tailored Care Manager provides person-centered, whole-person care coordination for members in Wilson, North Carolina. The role helps members access appropriate healthcare services, behavioral health support, community resources, and other essential services. The Care Manager works with members, families, caregivers, healthcare providers, and community organizations to promote wellness, independence, community integration, and quality of life, in accordance with North Carolina Department of Health and Human Services requirements. The position involves coordinating services across healthcare, behavioral health, and community-based support systems; supporting members and families in navigating services and advocating for their rights; and helping connect people to resources that support employment, education, socialization, independent living, and family well-being. Care Managers develop individualized care plans and crisis plans with members and the care team, maintain required contact frequencies based on member acuity, and provide crisis response as required, including face-to-face response to qualifying crises within two hours. The Care Manager works under the supervision of the Supervising Care Manager, maintains accurate documentation, and participates in required supervision, training, and professional development. Employees must maintain required training and certifications and deliver services promptly and in compliance with applicable regulations.

Requirements

Bachelor’s degree in health, psychology, sociology, social work, nursing, or another relevant human services field, or an RN license.
At least two years of experience working directly with the population served: people with behavioral health conditions when serving members with behavioral health needs, or people with intellectual or developmental disabilities (I/DD) or traumatic brain injuries (TBI) when serving members with those needs.
Maintain Nonviolent Crisis Intervention (NCI), Community First Aid/CPR, and any additional certifications required for the position.
Strong communication, organizational, problem-solving, documentation, and care coordination skills.
Ability to collaborate with members, families, healthcare professionals, and community service providers while maintaining professional standards and regulatory compliance.
Maintain training required by applicable state and federal laws and regulations, including training in BH I/DD Tailored Plan eligibility and services, whole-person health and identification of unmet resource needs, community integration, components of Health Home Care Management, and health promotion.
Ability to maintain required member contact frequencies based on acuity.
Ability to provide 24/7/365 first-responder crisis support as required and respond face-to-face to qualifying crisis situations within two hours.

Responsibilities

Provide professional care management services within the scope of NC DHHS Tailored Plan requirements.
Coordinate and monitor services across healthcare, behavioral health, and community-based support systems.
Connect members and caregivers with services such as peer support, respite care, self-help programs, and other community resources, and ensure requested referrals are completed promptly.
Educate members and families about self-advocacy, available services, and navigating healthcare and social service systems.
Explain members’ rights, protections, and responsibilities, including provider changes, grievance and complaint procedures, and fair hearing processes.
Promote wellness, preventive care, and whole-person health.
Assist members in understanding advance directives, psychiatric advance directives when appropriate, and guardianship options or alternatives.
Connect members and families to resources that promote employment, educational success, socialization, independent living, and community integration.
Help members develop adaptive skills and improve their ability to access and navigate services.
Collaborate with families and youth on strategies that strengthen family support, self-determination, and self-sufficiency.
Identify natural supports, social networks, and community resources to promote family-driven and youth-guided services.
Support service delivery in members’ communities and in the least restrictive appropriate settings.
For high-risk pregnant members, assess broader family needs, provide appropriate family planning guidance, and initiate discussions about an Infant Plan of Safe Care when applicable.
Develop and implement individualized care plans and proactive and reactive crisis plans with members, families, and the care team.
Provide first-responder crisis support on a 24/7/365 basis as required and maintain the capacity to respond face-to-face to qualifying crises within two hours.
Ensure access to members’ crisis plans and coordinate responses to emerging needs.
Collaborate with the care team to identify risks, establish response procedures, and promote member safety and stability.
Maintain minimum member contact frequencies based on assessed acuity: at least four monthly contacts, including one in-person contact, for high acuity; at least three monthly contacts and one in-person contact per quarter for moderate acuity; and at least two monthly contacts and two in-person contacts per year for low acuity.
Maintain accurate documentation of care management activities, member needs, referrals, and services.
Work under the supervision of the Supervising Care Manager in accordance with individualized supervision plans.
Participate in required supervision, training, and professional development activities and maintain required training.
Deliver services promptly, responsibly, and in compliance with applicable state and federal regulations.
Complete other duties as assigned.