I/DD Care Manager, QP (Gaston/Cleveland/Rutherford NC)-Mobile

Partners Behavioral Health Management • Gastonia, NC

96d

About The Position

The Intellectual and Developmental Disabilities (I/DD) Care Manager is responsible for providing Tailored Care Management and/or care coordination to members/recipients with I/DD to help secure and coordinate a variety of physical health, developmental disability, behavioral health and long-term services and support (LTSS) services. The I/DD Care Manager actively engages with members/recipients through comprehensive assessment, care planning, health promotion, and comprehensive transitional care. Tailored Care Management is comprehensive and longitudinal for members with Medicaid coverage. Recipients with no Medicaid receive Tailored Care Management based on specified triggers and for a duration not to exceed ninety (90) days. Travel is an essential function of this position.

Requirements

• Bachelor’s degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area and two (2) years of full-time experience with I/DD population.
• Bachelor’s degree in a field other than human services and four (4) years of full-time experience with I/DD population.
• Master’s degree in human services and one (1) year of full-time experience with I/DD population.
• Licensure as a registered nurse (RN) and four (4) years of full-time accumulated experience with I/DD.
• Two (2) years of prior Long-Term Services and Supports (LTSS) and/or Home and Community Based Services (HCBS) coordination, care delivery monitoring and care management experience.
• Must reside in North Carolina.
• Must have ability to travel regularly as needed to perform job duties.

Nice To Haves

• Experience working with member/recipients with co-occurring physical health and/or behavioral health needs preferred.

Responsibilities

• Provide assessment and care management services aimed at the integration of primary, behavioral and specialty health care and community support services.
• Complete a care management comprehensive assessment within required timelines and update as needed.
• Develop a comprehensive Individual Support Plan and update as needed.
• Provide diversion activities to support community tenure.
• Facilitate access to and the monitoring of services identified in the Individual Support Plan.
• Facilitate communication and regularly scheduled interdisciplinary team meetings to review care plans and assess progress.
• Monitor services for compliance with state standards and Medicaid regulations.
• Verify that services are delivered as outlined in ISP and address any deviations.
• Provide education and guidance on self-management and self-advocacy.
• Educate members and recipients about the Registry of Unmet Needs.
• Utilize person-centered planning methods/strategies to gather information.
• Ensure that members/legally responsible persons are informed of services available.
• Promote prevention and health through education on the member’s chronic conditions.
• Educate and engage the member/recipient and caregivers in making decisions that promote independent living skills.
• Closely coordinate care with the member’s I/DD, behavioral health, and physical health providers.
• Support medication management as prescribed by medical providers.
• Create and implement a 90-day transition plan as an amendment to the ISP.
• Provide information and assistance in referring members/recipients to community-based resources.
• Assist members who are receiving care management from other entities with referral/linkage to I/DD services.
• Participate in weekly conference with CCNC, as needed.
• Assist state-funded recipients apply for Medicaid.
• Coordinate Medicaid deductibles, as applicable.
• Proactively monitor documentation/billing to ensure that issues/errors are resolved.
• Ensure all clinical documentation meets state, agency and Medicaid requirements.
• Recognize and report critical incidents.
• Promote member satisfaction through ongoing communication.
• Collaborate with providers to ensure accurate/timely submission of authorization requests.

Benefits

• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
• Public Service Loan Forgiveness Qualifying Employer

What This Job Offers

• Education Level: Bachelor's degree
• Number of Employees: 101-250 employees