Special Programs Case Manager Lead(1915i/IDD Team)

Elevance Health • Durham, NC

2d • Hybrid

About The Position

The Special Programs Case Manager Lead coordinates operations and workflows related to case management activities in support of specialty programs, such as Foster Care. The role serves as a coach, performs case management telephonically and/or through home visits within the scope of licensure, and manages overall healthcare costs for a designated population through integrated physical and behavioral health case management and whole-person care. The Lead manages the most complex cases and supports Special Programs case managers.

This field-based position is in North Carolina. Associates primarily work in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training. Alternate locations may be considered for candidates within commuting distance of an office. Elevance Health’s hybrid workforce strategy generally requires associates to work at an Elevance Health location at least once per week unless the position is specified as primarily virtual.

The role may lead specialty projects and initiatives, support process improvements, train and mentor staff, conduct case and chart audits, ensure departmental compliance, and serve on the leadership team.

Requirements

• Master’s degree in social work, counseling, or a related behavioral health field; or a nursing degree and at least 7 years of clinical experience in social work counseling with broad experience in complex psychiatric and substance abuse or substance use disorder treatment; or an equivalent combination of education and experience.
• 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 U.S. states or territories.

Nice To Haves

• Experience working with specialty populations.
• Clinical experience in social work counseling involving a broad range of complex psychiatric/substance abuse and/or medical disorders.

Responsibilities

• Conduct assessments to identify individual needs.
• Develop comprehensive care plans based on assessment objectives and goals, support access to appropriate quality and cost-effective care, and modify plans as needed.
• Coordinate internal and external resources to address members’ integrated physical and behavioral health needs.
• Coordinate social determinants of health and incorporate them into care planning.
• Work closely with state agencies.
• Maintain knowledge of the system of care philosophy and coordinated community-based services and supports for people with or at risk for mental health or other challenges and their families.
• Build meaningful partnerships with designated populations and their families, addressing cultural and linguistic needs to help them function at home, in the community, and throughout life.
• Evaluate health needs and identify applicable services and resources with members and their families.
• Provide patient education, medication reconciliation, and information about community resources, and assist with follow-up care arrangements.
• Facilitate health rounds with other clinical professionals to support whole-person health.
• Lead and work on specialty projects and initiatives as needed.
• Assist with process improvement activities.
• Train and mentor staff.
• Perform case and chart audits and ensure departmental compliance.
• Serve as a member of the leadership team.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs (unless covered by a collective bargaining agreement)
• Medical benefits
• Dental benefits
• Vision benefits
• Short- and long-term disability benefits
• 401(k) with match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Senior