Tailored Care Manager For Moore County

Position Summary

The Tailored Plan Care Manager will address the needs of the population served by assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required by using communication and available resources to promote quality, cost-effective health outcomes.

The TP Care Manager will collaborate with the Primary Care Provider, member, guardian, caregivers, family members, other members of the Care Management Team, and the community to coordinate a full continuum of health care services. Holistic needs of the member, inclusive of unique social and cultural dynamics should be considered. The Care Manager may work remotely within regions to cover the needs across the state.

Essential Functions

• Provide effective Care Management services based on case management standards of practice to enrolled populations.
• Complete member assessments considering the total individual, inclusive of medical, biopsychosocial, behavioral, spiritual, and cultural needs to enrolled population, throughout the continuum of care.
• Work with members to identify and address behavioral, social, cultural, and environmental strengths and barriers as it relates to his/her diagnosis, treatment, and access to care.
• Provide education to member/family about clinical diagnosis, medications, available resources, prevention, and risk factors to achieve optimal self-management.
• Monitor quality and effectiveness of interventions to the enrolled populations by setting patient-centered SMART goals in collaboration with the members/families.
• Develop, review, implement, and evaluate the member care plan in partnership with the member, caregiver/guardian/family members, providers, and Care Management team members, as applicable.
• Incorporate therapeutic skills and techniques such as trauma-informed care, motivational interviewing, strengths-based, and solution-focused modalities to help members achieve healing, growth, health, and wellness.
• Utilize Hospital/Data or Electronic Medical Record system as available.
• Per guidance, facilitate referrals for members/families to appropriate community-based services and agencies.
• Refer to appropriate clinical team members for interventions which are outside the Care Managers’ scope of practice and/or expertise.
• Work collaboratively with multi-disciplinary team members to facilitate achievement of desired treatment outcomes.
• Engage and maintain collaborative relationships with community provider agencies that promote quality care and cost-effective health care utilization.
• Serve as a liaison among the member/family/guardian, community services, primary providers, specialists, and other care team members to coordinate services without duplication.
• Respect member’s values, experience, and help to empower members to be an advocate for their own care.
• Maintain appropriate member documentation in the Care Management documentation platform, in accordance with organizational policies and procedures.
• Meet monthly productivity and role expectations.
• Understand, uphold, and abide by CCNC and AMH+ company and department policies, goals, standards, and objectives.
• Adhere to CCNC and AMH+ privacy, security policies, and HIPAA regulations to ensure that patient and company data are properly safeguarded.
• Attend departmental and corporate meetings, local and regional trainings, or other events as required.
• Perform all other duties as requested.
• Travel using personal vehicle will be required within the region and/or the State.

Qualifications

Registered Nurse (RN)

• Graduation from an accredited school of nursing
• BSN preferred.
• Active, unrestricted RN license to practice in North Carolina.
• Two years of experience providing care management, case management, or care coordination to the population being served.
• CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements.
• Meets licensure or educational eligibility requirements as determined by The Commission for Case Management Certification.
• Access to Hospital/Data or Electronic Medical Record system will be required, as necessary.
• Maintain a valid driver’s license with current auto liability insurance.

Social Worker

• Master’s degree from an accredited school of social work.
• Two years of experience providing care management, case management, or care coordination to the population being served.
• Minimum 2 years’ social work experience; 1-year case management or community-based social work preferred.
• Active NC license as a Licensed Clinical Social Worker (LCSW).
• CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements.
• Meets licensure or educational eligibility requirements as determined by The Commission for Case Management Certification.
• Access to Hospital/Data or Electronic Medical Record system will be required, as necessary.
• Maintain a valid driver’s license with current auto liability insurance.

Additional Qualifications

Licensed Marriage and Family Therapist (LMFT), Licensed Clinical Addiction Specialist (LCAS), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Psychological Associate (LPA).

Knowledge, Skills, and Abilities

• Computer skills required including various office software and the internet; experience with MS Office software preferred.
• Excellent communication skills – oral and written; Bilingual preferred.
• Knowledge of government, private sector, and community resources.
• Knowledge of Case Management principles.
• Knowledge of and compliance with federal and state regulations applicable to the position.
• Strong organizational and time management skills.
• Skills in establishing rapport with a member and applying techniques of assessing comprehensive health care needs.
• Critical thinking skills, effective clinical judgment, independent decision-making, and problem-solving abilities.
• Sensitivity to diversity of cultures, language barriers, health literacy, and educational levels.
• Ability to work independently and function as an integral part of a multi-disciplinary team.
• Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives.
• Able to shift strategy or approach in response to the demands of a situation.

Working Conditions