Special Programs Case Mgr I

Elevance Health

31d • Hybrid

About The Position

Clinical Care Advisor - Complex Medical is responsible for the Children and Families Specialty Plan integrated physical health and behavioral health care management teams and the development, implementation and coordination of a comprehensive clinical program designed specifically to manage the health and wellness outcomes of youth in foster care and adoption assistance, including highly complex members with varying degrees of medical and behavioral health complexity and acuity. Manages overall healthcare costs, case management and whole person health.

Requirements

• Requires an active and current license as an LCSW, LCMHC, LPC, LMFT, or RN issued by the state of North Carolina.
• Requires a MS/MA in social work, counseling, or a related behavioral health field, or a degree in nursing.
• Requires three (3) years of experience providing care management, case management, or care coordination to individuals served by the child welfare system.

Nice To Haves

• Experience working with Children, Youth, and Families who are being served by Local Departments of Social Services through Foster Care and Adoptive Assistance programs is strongly preferred.
• Certified Case Manager Certification is highly preferred.
• Experience serving the children and youth involved in Foster Care and Social Services is strongly preferred.
• Prior experience in managing the delivery of services to meet the needs of children and youth with complex medical conditions is strongly preferred.
• Knowledge of resources, supports, services and opportunities required for safe community living for populations receiving in-reach and transition services, including Complex Medical, Behavioral Health, and/or IDD is strongly preferred.
• Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred.
• Travels to worksite and other locations as necessary.

Responsibilities

• Engage collaboratively with key stakeholders—including families, foster parents, and service teams—to craft and sustain individualized treatment plans.
• 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 member and incorporates that into care planning.
• Works closely with various state agencies.
• Maintains knowledge of the system of care philosophy; a spectrum of effective, community-based services and supports 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, in order 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.
• Facilitates health rounds with other clinical centered professionals to ensure whole person health.
• May lead and work on specialty projects and initiatives.
• Assists with process improvements activities.
• Trains and mentors staff.
• Performs case/chart audits and ensures departmental compliance.
• Serves as a member of the leadership team.

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees