Care Manager – LP
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Job Description
Care Manager coordinating assessments, care plans, and clinical services for Vaya Health members. Supporting behavioral health, I/DD, TBI, medical, and community-based care.
Responsibilities:
- Provide proactive intervention and coordination of care to eligible Vaya Health members and recipients
- Assess members’ behavioral, developmental, medical, social, pharmacy, LTSS, and unmet health-related resource needs
- Identify and alleviate inappropriate levels of care and care gaps through assessment, multidisciplinary care planning, and service coordination
- Conduct Health Risk Assessments and administer screenings including PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other needs-based screenings
- Review and document current medications and maintain integrated medication lists in Vaya’s care management platform
- Develop, update, and monitor person-centered care plans and crisis plans
- Link members with formal and informal services and supports across health domains
- Provide education, self-management strategies, crisis intervention, clinical consultation, and recommendations for appropriate care
- Review provider clinical assessments for accuracy and completeness; consult with providers on complex clinical needs
- Facilitate interdisciplinary care team, high-risk team, complex case staffing, and care planning meetings
- Support transitional care management, discharge follow-up, and diversion from institutional placement
- Collaborate with RNs, pharmacists, physicians, providers, families, caregivers, DSS, DJJ, CCNC, schools, and community stakeholders
- Monitor service provision, member health and safety, critical incidents, quality, eligibility, and care management outcomes
- Maintain accurate, timely, and compliant documentation in the administrative health record
- Participate in trainings, committees, workgroups, multidisciplinary huddles, and other departmental projects
- Perform other duties as assigned
Requirements:
- Master’s degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services area
- For non-nursing master’s degree holders: two years of experience working directly with individuals with behavioral health conditions
- For non-nursing master’s degree holders serving LTSS needs: two years of prior Long-Term Services and Supports and/or Home and Community Based Services coordination, care delivery monitoring, and care management experience
- For master’s degree holders in nursing: four years of full-time accumulated experience in mental health with the population served
- Must meet the criteria of being a North Carolina Qualified Professional with the population served under 10A NCAC 27G .0104
- Valid licensure required; acceptable licenses include RN, LCSW, LCSWA, LCMHC, LCMHCA, LCMHCS, LPA, HSP-PA, LCAS, LCASA, LMFT, or LMFTA
- Experience working directly with individuals with I/DD or TBI preferred
- Proficiency with Vaya’s Care Management software platform/administrative health record
- Compliance with HIPAA and Authorization for Release of Information practices
- Proficiency in Microsoft Office products, including Word, Excel, PowerPoint, Outlook, and Teams
- Knowledge of the DSM current version within the candidate’s scope
- Considerable knowledge of the MH/SU/IDD/TBI service array provided through Vaya’s provider network
- Ability to complete and maintain all required Vaya trainings and proficiencies
- Ability to drive and sit for extended periods, including in rural areas
- Ability to perform clinical assessments and identify member needs
- Strong problem-solving, negotiation, arbitration, conflict-resolution, organizational, and communication capabilities
- Must reside in North Carolina or within 40 miles of the North Carolina border
- Ability to travel and deliver in-person contacts with members and care teams
Benefits:
- Exempt position; not eligible for overtime compensation
- Mobile position with work done in a variety of locations
- Vaya Health equal opportunity employer
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