Care Manager – QP

🔥 4 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $54.2k - $70.2k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

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Partners Health Management

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2012

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance • Health Care

Partners Health Management is a local management entity and managed care organization that focuses on providing essential mental health services, supports for individuals with intellectual and developmental disabilities, and substance use disorder services. Their mission is to assist members and their families in accessing the necessary care and resources to improve their overall well-being and integration into the community.

📋 Description

• Provide proactive intervention and coordination of care to eligible Vaya Partners Health members and recipients • Assess members’ behavioral, developmental, medical, social, and resource needs through Health Risk Assessments • Develop, update, and support person-centered care plans and crisis plans • Link members with appropriate formal and informal services and supports across health domains • Administer PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other screenings within scope • Review and document medications and maintain multisource medication lists • Participate in interdisciplinary care team meetings and multidisciplinary case staffing • Provide education, self-management strategies, referrals, crisis intervention, and care management • Support transitional care management and diversion efforts for members at risk of institutional placement • Coordinate with members, legally responsible persons, providers, relatives, caregivers, nurses, pharmacists, community stakeholders, DSS, DJJ, CCNC, and school systems • Identify system barriers and service-access gaps within Vaya Partners’ catchment • Monitor provider services, quality of care, compliance, critical incidents, and member health and safety • Verify Medicaid eligibility and address member movement outside Vaya Partners’ catchment area • Create and monitor accurate, complete documentation in the administrative health record • Maintain electronic administrative health record compliance and complete required trainings • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree required, preferably in health, psychology, sociology, social work, nursing, or another relevant human services area • Two years of experience working directly with individuals with behavioral health conditions • Two years of prior Long-term Services and Supports (LTSS) and/or Home Community Based Services (HCBS) coordination, care delivery monitoring, and care management experience • Must meet the criteria of a North Carolina Qualified Professional with the population served under 10A NCAC 27G .0104 • If the incumbent has a Bachelor’s degree in nursing and RN, must be licensed by the North Carolina Board of Nursing to practice in North Carolina • Experience requirements vary by degree and field: two years for a Human Services bachelor’s degree; four years for a non-Human Services bachelor’s degree; four years for a Bachelor’s degree in Nursing with RN; at least two years for a Master’s degree in Human Services • Preferred experience working directly with individuals with I/DD or TBI • Knowledge of the Diagnostic and Statistical Manual of Mental Disorders (current version) • 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 • Intermediate to advanced proficiency in Microsoft Office products, including Word, Excel, PowerPoint, Outlook, and Teams • Proficiency in Vaya Partners’ care management platform, administrative health record, data analysis, and secondary research • Ability to complete and maintain required Vaya Partners trainings and proficiencies • Ability to drive and sit for extended periods, including in rural areas • Ability to communicate effectively, solve problems, negotiate, arbitrate, resolve conflicts, make independent decisions, and adapt to changing priorities • Must reside in North Carolina or within 40 miles of the North Carolina border • Must be able to travel and deliver in-person contacts in or near the counties served

🏖️ Benefits

• Non-exempt position eligible for overtime compensation • Equal opportunity employer

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