Special Programs Case Manager I

Elevance Health•Durham, NC

1d•Hybrid

About The Position

The Special Programs Case Manager I is responsible for performing case management telephonically and/or by home visits within the scope of licensure for special programs, such as Foster Care. Manage overall healthcare costs for the designated population via integrated (physical health/behavioral health) case management and whole person’s health. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Alternate locations may be considered if candidates reside within a commuting distance from an office. North Carolina residency is required.

Requirements

Requires MS/MA in social work, counseling, or a related behavioral health field or a degree in nursing and minimum of 3 years of clinical experience in social work counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background.
Requires an active, current and valid license as an RN, LCSW (as applicable by state law and scope of practice), LMHC, LPC (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States.

Nice To Haves

Experience working with specialty populations preferred.
Clinical experience in social work counseling with a broad range of complex psychiatric/substance abuse and/or medical disorders preferred.
Being able to travel within your assigned DSS Region is highly preferred.
We are unable to accommodate LCSW-A, LCMHC-A or any other associate level licenses

Responsibilities

Conducts assessments to identify individual needs.
Develops comprehensive care plan to address objectives and goals as identified during assessment.
Supports member access to appropriate quality and cost-effective care and modifies plan(s) as needed.
Coordinates with internal and external resources to meet identified needs of the member in terms of integrated (physical and behavioral) whole person care.
Coordinates social determinants of health to meet the needs of the members and incorporates that into care planning.
Works closely with various state agencies.
Maintains knowledge of the philosophy system of care; a spectrum of effective, community-based services and support for those with or at risk for mental health or other challenges and their families, that is organized into a coordinated network.
Builds meaningful partnerships with designated populations and their families, and addresses cultural and linguistic needs, to help them function better at home, in the community, and throughout life.
Evaluates health needs and identifies applicable services and resources in conjunction with members and their families.
Provides important information including patient education, medication reconciliation, and identification of community resources and assists with arrangement of follow-up care.