I/DD Care Manager – QP

🔥 3 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $54k - $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 Tailored Care Management and/or care coordination to members/recipients with intellectual and developmental disabilities (I/DD) • Secure and coordinate physical health, developmental disability, behavioral health, and long-term services and supports (LTSS) • Engage members through comprehensive assessment, care planning, health promotion, and transitional care • Complete comprehensive care management and health risk assessments within required timelines • Develop and update comprehensive Care Plans/Individual Support Plans • Facilitate access to and monitor services identified in care plans • Facilitate interdisciplinary team meetings and assess member progress • Monitor services for compliance with state standards and Medicaid regulations • Verify service delivery and address deviations • Provide education and guidance on self-management, self-advocacy, rights, protections, responsibilities, and available services • Promote culturally competent services and supports • Coordinate care with I/DD, behavioral health, and physical health providers, including in-person visits to Emergency Departments and Skilled Nursing Facilities • Support medication management, treatment adherence monitoring, and monitoring of side effects and effectiveness • Create and implement 90-day transition plans during care transitions • Refer members to community-based resources and social support services • Assist with applications, renewals, and documentation for health-related services and Medicaid • Coordinate with other care management entities and participate in weekly conferences as needed • Monitor documentation and billing and resolve issues or errors • Maintain clinical documentation and medical record compliance/quality • Recognize and report critical incidents • Promote member satisfaction through communication and timely follow-up • Collaborate with providers on authorization requests for Tailored Plan-funded services • Document member concerns in the grievance system • Lead each member’s care team and direct Care Management extenders

🎯 Requirements

• Must live in or near Gaston, Cleveland, or Rutherford County, North Carolina • Must reside in North Carolina or within 40 miles of the North Carolina border • Must have ability to travel regularly as needed to perform job duties • Bachelor’s degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area and two (2) years of full-time experience with I/DD population OR Bachelor’s degree in a field other than human services and four (4) years of full-time experience with I/DD population OR Master’s degree in human services and one (1) year of full-time experience with I/DD population OR licensure as a registered nurse (RN) and four (4) years of full-time accumulated experience with I/DD • Two (2) years of prior Long-Term Services and Supports (LTSS) and/or Home and Community Based Services (HCBS) coordination, care delivery monitoring and care management experience; this experience may be concurrent with the I/DD population experience • Must be licensed in North Carolina if a Registered Nurse (RN) • Demonstrated knowledge of the assessment and treatment of I/DD needs, with or without co-occurring physical health, mental health or substance use disorder needs • Ability to develop strong, person-centered plans • Exceptional interpersonal skills and highly effective communication ability • Ability to collaborate and communicate effectively in a team environment • Ability to maintain effective and professional relationships with members/recipients, family members and care team members • Problem solving, negotiation and conflict resolution skills • Excellent computer skills, including proficiency in Microsoft Office products such as Word, Excel, and Outlook • Ability to learn and apply legal, waiver and program practices/requirements • Ability to independently organize multiple tasks and priorities and complete duties within assigned timeframes • Ability to manage and uphold integrity and confidentiality of sensitive data • Sensitivity and knowledge of different cultures, ethnicities, spiritual beliefs and sexual orientation • Ability to drive and sit for extended periods, including in rural areas • Bachelor’s/master’s degree and RN licensure options are alternatives; no experience-in-place-of-education alternative explicitly stated

🏖️ Benefits

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

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