Care Manager - LP

September 24

🌲 North Carolina – Remote

Although this job is listed in North Carolina, this company may be open to hiring remote in other states.

💵 $63k - $81.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

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Vaya Health

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Healthcare Insurance • Healthcare • Social Impact

Vaya Health is a North Carolina-based organization that manages services for individuals with behavioral health issues, including mental health and substance use disorders, intellectual and developmental disabilities (I/DD), and traumatic brain injuries (TBI). The organization provides Medicaid services tailored for these populations, focusing on a person-centered approach that connects members to the necessary care and support for their unique health and wellness goals. Vaya Health emphasizes collaboration across various care areas to ensure comprehensive support for its members, fostering healthier communities across the region.

501 - 1000 employees

Founded 1972

⚕️ Healthcare Insurance

🌍 Social Impact

📋 Description

• Provide proactive intervention and coordination of care to eligible Vaya Health members and recipients to ensure appropriate assessment and services. • Conduct Health Risk Assessments (HRA): comprehensive bio-psycho-social assessment addressing social determinants of health, mental health history and needs, physical health history and needs, activities of daily living, access to resources, and other areas. • Administer screenings (PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS) and transcribe member medication lists into Vaya’s Care Management platform to create multisource medication lists. • Support and participate in interdisciplinary care team meetings and comprehensive, person-centered care planning; ensure Care Plans include mental health, substance use, medical, social needs and NCDHHS-required elements. • Provide clinical transition planning assistance to hospitals and residential facilities; track discharges and ensure follow-up aftercare services to prevent rehospitalization. • Coordinate diversion from institutional placement and provide crisis intervention, coordination, and care management in community settings. • Review assessments conducted by providers for clinical accuracy; provide consultation and technical support; engage provider clinical staff to determine clinical appropriateness. • Manage and facilitate Child/Adult High-Risk Team meetings with community stakeholders and partner with other Vaya departments to identify and address gaps in services/access to care. • Maintain electronic AHR compliance and documentation quality; ensure clinical and non-clinical documentation meet federal, state, and Vaya requirements. • Verify member continuing eligibility for Medicaid and proactively address changes in Medicaid county of eligibility. • Participate in required Vaya/Care Management trainings, multidisciplinary huddles, committees, workgroups, and other projects as requested. • Mobile position: work in a variety of locations including members’ home communities and travel within designated counties.

🎯 Requirements

• Must reside in North Carolina or within 40 miles of the North Carolina border (NC Residency Requirement). • Master’s degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area. • For incumbents with a Master’s Degree in a Human Services Area besides Nursing: Two (2) years of experience working directly with individuals with BH conditions OR Two (2) years prior Long-tern Services and Supports and/or Home Community Based Services coordination, care delivery monitoring and care management experience (may be concurrent). • For incumbents with a Master’s Degree in Nursing: Four (4) years of full-time accumulated experience in mental health with the population served (experience can be before or after obtaining RN licensure). • Must meet the criteria of being a North Carolina Qualified Professional with the population served in 10A NCAC 27G .0104. • Valid licensure required: Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Clinical Social Worker Associate (LCSWA), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Clinical Mental Health Counselor Associate (LCMHCA), Licensed Clinical Mental Health Counselor Supervisor (LCMHCS), Licensed Psychological Associate (LPA), Health Services Professional Psychological Associate (HSP-PA), Licensed Clinical Addiction Specialist (LCAS), Licensed Clinical Addiction Specialist Associate (LCASA), Licensed Marriage and Family Therapist (LMFT) or Licensed Marriage Family Therapist Associate (LMFTA). • Ability to drive and sit for extended periods of time (including in rural areas). • Physical requirements: Close visual acuity; crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists, and fingers; sedentary work with lifting up to 10 pounds. • Proficiency in Microsoft office products (Word, Excel, Power Point, Outlook, Teams, etc.) and Vaya systems, to include the care management platform, data analysis, and secondary research. • Knowledge of the Diagnostic and Statistical Manual of Mental Disorders (current version) within scope and considerable knowledge of the MH/SU/IDD/TBI service array. • Experience and knowledge of the NC Medicaid program, NC Medicaid Transformation, Tailored Plans, state-funded services, and accreditation requirements preferred. • Compliance with HIPAA requirements and Authorization for Release of Information (ROI) practices. • Ability to administer PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other screenings. • Ability to complete and maintain all required trainings and proficiencies.