Care Manager – LP

🕒 Yesterday

🌲 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 and recipients • Conduct comprehensive bio-psycho-social Health Risk Assessments covering social determinants of health, behavioral and physical health, daily living activities, and resource access • Develop, update, and monitor person-centered care plans, crisis plans, and treatment goals • Link members with formal and informal services and supports across medical, behavioral health, I/DD, TBI, pharmacy, LTSS, and unmet health-related resource 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 • Participate in and facilitate interdisciplinary care team meetings and complex case staffing • Provide clinical consultation and technical support to providers; review clinical assessments for accuracy and completeness • Provide clinical assessments when lack of a clinical home or network provider creates significant member risk • Provide crisis intervention, coordination, and care management in community settings • Support transitional care management and coordinate diversion efforts for members at risk of institutional placement • Collaborate with members, legally responsible persons, caregivers, providers, Vaya staff, DSS, DJJ, CCNC, schools, and community stakeholders • Monitor service provision, member health and safety, critical incidents, quality of care, and compliance • Verify continuing Medicaid eligibility and respond to members’ movement outside Vaya’s catchment area • Create and monitor accurate, timely documentation in the administrative health record • Maintain compliance with HIPAA, ROI practices, Vaya policies, NCDHHS requirements, and contractual obligations • Participate in trainings, committees, workgroups, huddles, and other departmental projects • Travel and conduct work in members’ home communities and other locations

🎯 Requirements

• Master’s degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services area • North Carolina Qualified Professional qualification 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 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 LTSS and/or HCBS coordination, care delivery monitoring, or care management experience; may be concurrent with behavioral health, I/DD, or TBI experience • For master’s degree holders in nursing: four years of full-time accumulated mental health experience with the population served; experience may be before or after RN licensure • Ability to complete and maintain all required Vaya trainings and proficiencies • Ability to perform clinical assessments using higher-level clinical training and licensure • Extensive understanding of the current Diagnostic and Statistical Manual of Mental Disorders within scope • Considerable knowledge of the MH/SU/IDD/TBI service array • Intermediate to advanced proficiency in Microsoft Office products and Vaya systems, including care management platform, data analysis, and secondary research • Knowledge of NC Medicaid, NC Medicaid Transformation, Tailored Plans, state-funded services, and accreditation requirements preferred • Ability to drive and sit for extended periods, including in rural areas • Must reside in North Carolina or within 40 miles of the North Carolina border • Must live in or near the counties served to effectively deliver in-person member contacts • Ability to communicate clearly and effectively • Strong problem-solving, negotiation, arbitration, conflict-resolution, organizational, and interpersonal skills

🏖️ Benefits

• Exempt position; not eligible for overtime compensation • Required Vaya/Care Management trainings and maintained training proficiencies • Equal opportunity employer