Care Manager – LP

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $63k - $75k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

👻 Ghost score 1%

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Vaya Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1972

🛡️ Insurance

💼 Consulting

📦 Logistics

Insurance • Consulting • Logistics

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.

📋 Description

• Provide proactive intervention and coordination of care to eligible Vaya Health members • 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 • Link members with appropriate formal and informal services and supports across health domains • Conduct comprehensive Health Risk Assessments addressing social determinants of health and whole-person needs • Administer PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other needs-based screenings • Review and transcribe medications and maintain multisource medication lists in Vaya’s care management platform • Support development, maintenance, and annual or life-change updates of person-centered care plans • Ensure care plans address mental health, substance use, medical, social, and personal goals and meet NCDHHS requirements • Review provider clinical assessments for accuracy, provide consultation and technical support, and interpret findings for care management • Engage provider clinical staff regarding treatment options and complex member needs • Facilitate care team meetings and collaborate with members, legally responsible persons, providers, RNs, pharmacists, physicians, families, and community stakeholders • Develop tailored Care Management Crisis Plans and provide crisis intervention, coordination, and care management when needed • Support Transitional Care Management and coordinate diversion efforts for members at risk of institutional placement • Manage and facilitate Child/Adult High-Risk Team meetings with DSS, DJJ, CCNC, school systems, and community stakeholders • Identify and address service and access-to-care gaps within Vaya’s catchment • Monitor service provision, quality of care, compliance, critical incidents, and member health and safety • Verify continuing Medicaid eligibility and respond to members’ movement outside Vaya’s catchment area • Create and monitor complete, accurate, and timely documentation in the administrative health record • Maintain compliance with HIPAA, Vaya policies, federal and state requirements, and NCDHHS contracts • Participate in trainings, multidisciplinary huddles, committees, workgroups, meetings, 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 • Must meet the criteria of being a North Carolina Qualified Professional with the population served under 10A NCAC 27G .0104 • Valid licensure required: RN, LCSW, LCSWA, LCMHC, LCMHCA, LCMHCS, LPA, HSP-PA, LCAS, LCASA, LMFT, or LMFTA • For a Master’s Degree in a Human Services Area besides Nursing: two years of experience working directly with individuals with BH conditions • For Human Services master’s degree holders serving members with LTSS needs: two years of prior Long-Term Services and Supports and/or Home Community Based Services coordination, care delivery monitoring, and care management experience; this may be concurrent with required behavioral-health experience or experience with individuals with I/DD or TBI • For a Master’s Degree in Nursing: four years of full-time accumulated experience in mental health with the population served; experience may be before or after RN licensure • Ability to express ideas clearly and communicate effectively • Ability to drive and sit for extended periods, including in rural areas • Exceptional interpersonal skills and professional representation of Vaya • Strong attention to detail and superior organizational skills • Ability to make prompt independent decisions based on relevant facts • Problem solving, negotiation, arbitration, and conflict resolution capabilities • Intermediate to advanced proficiency in Microsoft Office products and Vaya systems • Ability to perform clinical assessments and identify member needs • Extensive understanding of the current Diagnostic and Statistical Manual of Mental Disorders within 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 • Experience working directly with individuals with I/DD or TBI preferred • Must reside in North Carolina or within 40 miles of the North Carolina border

🏖️ Benefits

• Exempt position; not eligible for overtime compensation • Mobile position with work done in a variety of locations, including members’ home communities • Open until filled