Care Manager Jobs

About The Position

Requirements

• An Associates or bachelor’s degree in a human service field with two years MH/SA/DD experience with the population served; OR a licensed RN with two years MH/SA/DD experience with the population served. OR Masters w/ licensure, Masters in a human service field with one year MH/SA/DD experience with the population served OR Bachelors outside of human service field w/ 4 years’ MH/SA/DD experience with the population served.

Responsibilities

• Provides care management assessment/reassessment, development of care management plans, referring and linking to needed services, monitoring/follow up with client and referrals, provide education for health promotion.
• Ensure metrics for outcomes are met.
• Participates in interdisciplinary treatment planning, consultation activities and ensures all involved parties are aware of the plan of care.
• Provides crisis intervention consultation to all participants of TCM and involves crisis services when needed.
• Care Management Assessment: Documents the client’s service needs, strengths, resources, preferences, and goals to develop a Care Management Plan.
• Gathers information regarding all aspects of the recipient, including medical, physical, psychosocial, behavioral, financial, social, cultural, environmental, legal, and vocational/educational areas.
• Integrates all current assessments including the comprehensive clinical assessment and medical assessments, including assessments and information from the HIE/Tailored Plan and the primary care or specialty care physician.
• Includes early identification of conditions and needs for prevention and amelioration.
• Consults with other natural and paid supports such as family members, medical and behavioral health providers, and educators to form a complete assessment.
• Performs periodic reassessment to determine whether a recipient’s needs or preferences have changed.
• Care Management Plan/Documentation: Ensures that person centered information is gathered and that the consumer’s health and safety risks are assessed prior to the development of the care management plan.
• Works in conjunction with the client, family, friends, and providers who have lengthy experience with the person.
• Performs periodic revision of a plan based on the information collected from the person, family, other personal supports, and comprehensive clinical assessments or reassessments.
• Assist the person to obtain the outcomes/skills/symptom reduction that they desire.
• Contact the primary care physician to obtain clinical information pertinent to establishing person centered goals.
• Facilitates provider choice process, maintaining objectivity and providing fact-finding assistance.
• Ensures that signed Authorization to Disclose Health Information forms are obtained and on file in the consumer’s medical record prior to releasing any information when needed (Substance Use Disorders).
• Ensures that all information released/disclosed is documented on the Accounting of Release and Disclosure form (this includes documenting any documents given to consumer/legal guardian).
• Referral/Linkage: Referral and linkage activities connect a recipient with medical, behavioral, social and other programs, services, and supports to address identified needs and achieve goals specified in the Care Management Plan.
• Coordinating the delivery of services to reduce fragmentation of care and maximize mutually agreed upon outcomes.
• Facilitating access to and connecting recipients to services and supports identified in the Person Centered Plan.
• Making referrals to providers for needed services and scheduling appointments with the recipient.
• Assisting the recipient as he or she transitions through levels of care.
• Facilitating communication and collaboration among all service providers and the recipient.
• Assisting the recipient in establishing and maintaining a medical home where needed.
• Assisting the recipient in establishing OBGYN and prenatal care as necessary.
• Natural Support / Services Not Funded Through the Tailored Plan: Assists consumer/legally responsible person in considering and accessing natural community supports such as educational services, transportation, support from friends/family/church, etc.
• Ensures that the consumer gets the best possible treatment and care by carefully coordinating paid supports/services with other resources available in the community.
• Monitoring/Follow-Up: Monitoring and follow up includes activities and contacts that are necessary to ensure that the Care Management Plan is effectively implemented and adequately addresses the needs of the recipient.
• Monitoring activities may involve the recipient, his or her supports, providers, and others involved in care delivery.
• Monitoring activities helps determine whether: Services are being provided in accordance with the recipient’s Care Management Plan; Services in the Care Management Plan adequate and effective; There are changes in the needs or status of the recipient; and The recipient is making progress toward his or her goals.
• Documents monitoring and the actions taken/planned as a result of the monitoring in the consumer’s record.
• Ensures that the monitoring schedule for each consumer is sufficient to assure the health, safety and welfare of the consumer.
• Monitors for progress/lack of progress through observation, interview, and documentation review.
• Coordination: Works closely with the consumer/legally responsible person, provider agencies, and others involved with the consumer’s care and treatment to avoid/resolve scheduling conflicts, duplication of effort, and other problems that hinder effective treatment.
• Assists consumer in obtaining entitlement services whenever possible.
• Monitors the consumer’s continued eligibility for Medicaid and/or NC Health Choice, as applicable, and provides needed assistance to the consumer/legally responsible person in order to ensure that coverage does not lapse.
• Outcomes: Be responsible for the BH quality metrics for your assigned members Units Billed Minimum Requirement: Care manager contacts for members with behavioral health needs: High Acuity: At least four care manager-to-member contacts per month, including at least one in-person contact with the member. Moderate Acuity: At least three care manager-to-member contacts per month and at least one in-person contact with the member quarterly (includes care management comprehensive assessment if it was conducted in-person). Low Acuity: At least two care manager-to-member contacts per month and at least two in-person contacts with the member per year, approximately six months apart (includes the care management comprehensive assessment if it was conducted in-person).

Benefits

• Medical, Dental and Vision Insurance
• Health Spending Account
• Company-Paid Life Insurance
• Short Term Disability
• 401(k)
• Paid Holidays
• Paid Vacation and Sick Leave
• Employee Assistant Program
• Referral Bonus Opportunities
• Extensive Internal Training Program
• Hiring Bonus