CAP Case Manager / PT / Buncombe-Madison Area / Flexible Hours

RHA Health Services, LLC; Asheville (NC); Hybrid; USD 30,000 - 39,000; Full time

Job summary

RHA Health Services, LLC is seeking a CAP Case Manager (PT/Regular) to provide comprehensive case management in the Buncombe-Madison area. The role focuses on person-centered care planning, coordination of home-based services, and ongoing monitoring to prevent health and safety risks for beneficiaries with intellectual, developmental disabilities, mental health, and substance use needs.

Responsibilities include assessments, care planning, coordinating services, and ensuring regulatory

Qualifications

• Bachelor's degree in Social Work or related field required or equivalent experience.
• RN license and NC Medicaid training within 90 days preferred.
• Experience with case management in homecare, long-term care, or pediatric settings.
• Strong communication and record-keeping skills.
• Ability to coordinate services across multiple providers and agencies.
• Knowledge of Medicaid programs and compliance requirements.

Responsibilities

• Assess beneficiaries and families to evaluate medical, psychological, behavioral, and social needs.
• Educate families about waiver services, Medicaid, and community resources.
• Develop and maintain person-centered care plans and coordinate in-home services.
• Monitor and update plans regularly and document progress.
• Link beneficiaries to services, equipment, and supplies for home care.
• Collaborate with RNs, providers, and agencies to ensure comprehensive care.
• Ensure regulatory compliance and accurate billing documentation.
• Provide emotional support and guidance to families navigating care needs.
• Complete state-required trainings and maintain up-to-date CAP documentation.

Skills

Medicaid knowledge

Communication skills

Case management

Education

Bachelor's degree in Social Work

Bachelor's degree in Human Services

Bachelor's degree in non-human services

Registered Nurse (RN) license

Excellent communication and interpersonal skills

Ability to manage multiple priorities and detailed records

Experience with medically fragile children or pediatric healthcare

Job description

We are hiring for: CAP Case Manager / PT / Buncombe-Madison Area / Flexible Hours Type: Regular If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the lives of people with intellectual, developmental disabilities, and people facing mental health, and substance use challenges, join our team at RHA Health Services! The CAP Case Manager provides critical case management services to beneficiaries who are at risk of institutionalization, ensuring their health, safety, and well-being are maintained through person-centered care planning and coordination of essential services.

DUTIES AND RESPONSIBILITIES

Assessment and Care Planning: Conduct initial pre-screening and assessments of beneficiaries and their families to evaluate medical, psychological, behavioral, financial, social, cultural, environmental, legal, vocational, educational, and other areas.

Consultation with the CAP beneficiary and primary caregiver to educate about waiver services, other Medicaid, and community resources to meet the beneficiaries' needs.

Identify needs to prevent health and safety factors to assist in maintaining community placement.

Develop and maintain individualized, person-centered care plans (emergency and disaster planning) to ensure the health, safety, and well-being of beneficiaries.

Review and update care plans at least every 12 months or when the status of the beneficiary changes.

Assist beneficiaries and families in understanding the plan of care and making informed choices.

Coordination of Services: Link beneficiaries and their families to necessary services, equipment, and supplies to support care in the home.

Collaborate with community resources, healthcare providers, and other agencies to ensure comprehensive care delivery.

Initiate appropriate referrals and utilize community resources for planning and service coordination.

Monitoring and Follow-Up: Provide ongoing monitoring of services through monthly phone calls and home visits, documenting observations, and beneficiary progress.

Evaluate the effectiveness of care plans and services, recommending or implementing changes as needed to achieve desired outcomes.

Maintain accurate, up-to-date case management documentation within the system, ensuring compliance with state and agency guidelines.

Counseling and Support: Provide emotional support and basic counseling to beneficiaries and their families to strengthen their support systems.

Assist families in navigating challenges, including long-term palliative care, behavioral issues, and medical needs.

Documentation and Compliance: Assist in obtaining documentation from medical staff to confirm the need for specific CAP services.

Maintain medical records for each beneficiary, ensuring documentation of current status, service changes, and referrals.

Ensure compliance with 10A NCAC 27G.0202 and other regulatory guidelines.

Complete all required records per agency policy and the State CAP manual, including discharge summaries when CAP services are completed.

Review and ensure proper billing codes and compliance for case management, in-home aide documentation, paid live-in caregiver, re-certifications, and supply billing.

Participate in NC Medicaid-certified training programs and ensure program compliance within 90 days of employment.

Collaboration and Advocacy: Work closely with RNs and interdisciplinary team members to ensure a comprehensive approach to beneficiary care.

Participate in case discussions and provide input to ensure quality care and service delivery.

Advocate for program participants and their families to secure necessary resources and services.

Serve as a liaison between beneficiaries, families, and external providers to address care needs effectively.

Provide training and support to families to empower them in managing their child’s care.

Continuing Education and Professional Development: Complete all state-mandated training and agency-required continuing education annually.

Stay current on CAP guidelines, best practices, and new developments to enhance service delivery.

Ensure timely updates to the CAP Business system and other documentation systems as required.

All other duties as assigned.

This position has no supervisory responsibilities.

MINIMUM QUALIFICATIONS

Strong understanding of Medicaid programs and compliance requirements.

Excellent communication and interpersonal skills to work effectively with families and multidisciplinary teams.

Ability to manage multiple priorities and maintain detailed records.

Experience working with medically fragile children or in pediatric healthcare settings and physically disabled adults with complex care needs.

EDUCATION AND EXPERIENCE

Social Work Background: Bachelor's degree in social work from an accredited school of social work.

Minimum of one year of directly related community experience, preferably case management, in the health or medical field (homecare, long-term care, or personal care).

Completion of an NC Medicaid-certified training program within 90 calendar days of employment.

Human Services Background: Bachelor's degree in a human services or equivalent field from an accredited college or university.

Minimum of two years of community experience, preferably case management, in the health or medical field (homecare, long-term care, or personal care).

Completion of an NC Medicaid-certified training program within 90 calendar days of employment.

Non-Human Services Background: Bachelor's degree in a non-human services field with two or more years of related community experience, preferably case management, in the health or medical field (homecare, long-term care, or personal care).

Completion of an NC Medicaid-certified training program within 90 calendar days of employment.

Nursing Background: Current North Carolina Registered Nurse (RN) license with a two-year or four-year degree.

At least one year of case management experience in homecare, long-term care, or personal care.

Completion of an NC Medicaid-certified training program within 90 calendar days of employment.

Note: An individual with a Bachelor's degree or who holds a nursing license as described above, without the number of years of experience, may be designated as an apprentice and shall be hired to act in the role of case manager. The supervisor of the case management shall provide direct supervision and approve all CAP/C workflow documentation and tasks.

PHYSICAL DEMANDS AND WORK ENVIRONMENT

Must be able to lift a minimum of 10 lbs.

Must be able to pull a minimum of 20 lbs.

Must be able to squat, kneel, crawl, crouch, climb, and stoop.

Required to regularly stand and walk.

EEO STATEMENT

RHA is an Equal Employment Opportunity Employer, prohibits discrimination based on the following protected categories: race, creed