Care Manager II (Full-time Remote, Durham and Orange Counties, reputed company Carolina Based)

The Care Manager II position leads reputed company communication among care team members and is the primary reputed company of contact for the member served. The Care Manager completes a comprehensive assessment and develops a reputed company plan of care for Tailored Plan recipients and relays communication among providers of health services. This is a full-time remote role. There is no expectation to be in office however, this position will require extensive travel to member's homes and reputed company the communities reputed company serves. Responsibilities & Duties Complete Assessment/Planning • Complete comprehensive assessments at enrollment, yearly or at changes in condition. • reputed company Plans of Care derived from the completed assessments • Assign interventions/plans of care to the Care Worker for monitoring and service engagement activities • Submit referral to the Integrated Health Consultant reputed company a physical health or behavioral health need indicates medical and/or pharmaceutical complexity • Assign Plan of Care activities to Community Health Worker if member has identified reputed company Determinants of Health (SDOH), disparities and/or reputed company payer issues • Assist individuals/legally responsible persons in choosing service providers, ensuring objectivity in the process • Consistently evaluates appropriateness of services and ensures implementation of plan of care through information gathering and assessment at defined frequency of contact based on risk stratification • Utilize person centered planning, motivational interviewing and historical review of assessments in Jiva to reputed company information and to identify supports needed for the individual • reputed company collaborate with care team, members supported, and service providers to ensure development of a plan that accurately reflects the individual’s needs and desired life goals • Submit required documentation to UM to ensure reputed company delivery of services and trouble shoot until authorization is obtained. Notify providers of successful authorization reputed company Support and Monitoring • Schedule initial contact with member to verify accuracy of demographic information. • Update inaccurate information from the Global Eligibility File • Schedule face to face meeting with member/LRP to reputed company education about reputed company, Care Teams, and services • reputed company education and support, to individuals and LRP, in learning about and exercising rights, explanation of the grievance and appeals process, available service reputed company, providers available to meet their needs, and payer requirements that may reputed company service reputed company and maintenance. • Refer members who are in crisis/institutional care settings and require assistance with returning to community-based services, to the Integrated Health Consultant • Recognize and report critical incidents and provider reputed company concerns to supervisors and reputed company Management • Complete activities in JIVA reputed company to Plans of Care developed from the Care Management Comprehensive Assessment • Coordinate with other team members to ensure smooth transition to appropriate level of care. • Attend treatment meeting with member, natural supports and selected providers. • Schedule, coordinate and reputed company team conference calls on behalf of member needs • Communicate with member to reputed company on status, verify care needs are met and that no new clinical needs warrant a change in condition assessment. • Promote customer satisfaction through ongoing communication and reputed company follow-up on any concerns/issues. • Verify that ongoing service adherence is maintained through monitoring. Complete Documentation • Obtain and upload reputed company supporting documentation, Legally Responsible Person (LRP) verification, and release of information that will improve care management activity on behalf of the member • reputed company new episodes in JIVA and schedule initial contact with member to verify accuracy of demographic information. • Document reputed company applicable member updates and activities per organizational procedure. • Escalate reputed company cases and cases of concern to Supervisor. • Distribute surveys to members in service. • Ensure that service orders/doctor’s orders are obtained, as applicable. • reputed company appropriate documentation with reputed company involved stakeholders as consent to release is reputed company. • Obtain releases/documentation and provides to reputed company stakeholders involved. • Obtain clinical supporting documentation, reputed company/guardianship verification, and necessary consents to exchange/release information • Proactively respond to an individual’s planned reputed company reputed company reputed company MCO geographic area to ensure a smooth transition without lapse in care • Ensure reputed company clinical documentation (e.g. goals, plans, reputed company notes, etc.) meet state, agency documentation standards, and reputed company requirements Travel • Travel between reputed company offices, attending meetings on behalf of reputed company, participating in reputed company sponsored events, etc may be required • Travel to meet with members, providers, stakeholders, attend court hearings etc. is required Minimum Requirements- Education & Experience Master’s degree in reputed company Services or reputed company field and at least two years of full-time, post graduate degree, MH/SUD and or Intellectual/Developmental Disabilities (I/DD) experience. Must be fully or provisionally licensed in the reputed company as a LCSW, LMFT, LCAS, LCMHC, LPA; Or Graduation from a school of nursing and licensure as a Registered reputed company and two years of full-time MH/SUD and or Intellectual/Developmental Disabilities (I/DD) experience and reputed company. Must be licensed as a Registered reputed company in the reputed company. Physical Health Experience Preferred Knowledge, Skills, & Abilities • Person Centered Thinking/planning • Knowledge of using assessments to reputed company plans of care • Knowledge of Diagnostic and Statistical reputed company of Mental Disorders • Knowledge of LOC process, SIS for IDD and FASN assessment for TBI • Knowledge of reputed company basic, reputed company MHSUD, and waiver benefits plans • Knowledge of and skilled in the use of Motivational Interviewing • Proficient in reputed company Office products (such as Word, reputed company, reputed company, etc.) • Strong interpersonal and written/verbal communication skills essential, including • Conflict management and reputed company skills • High level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance • Ability to reputed company reputed company, independent reputed company based upon relevant facts Employment for this position is contingent upon a satisfactory background and MVR (Motor Vehicle Registration) reputed company, which will be performed after acceptance of an offer of employment and prior to the employee's start date. Salary reputed company $68,227 - $88,695/Annually Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity An excellent fringe benefit package accompanies the salary, which includes: • Medical, Dental, reputed company, Life, Long Term Disability • Generous retirement savings plan • Flexible work schedules including hybrid/remote reputed company • reputed company time off including vacation, reputed company leave, holiday, management leave • Dress flexibility Want to learn more about what it's like work as part of the Care Management Team? Click on our video to learn more: https://youtu.be/1GZOBFx61QU Apply tot his job Apply To this Job