Care Management Consultant- (RN), (PT) or (OT), Licensed Candidates Encouraged to Apply, (Full-[...]

Alliance Health in; Morrisville (NC); Remote; USD 66,000 - 85,000; Full time

Job summary

A leading healthcare provider is seeking a Care Management Consultant to join their multidisciplinary team. This full-time remote position requires a licensed RN, OT, or PT to provide consultative care management for members with physical health needs. Responsibilities include supporting transitions of care, conducting assessments, and collaborating with healthcare providers to optimize member outcomes. The role offers competitive salary and comprehensive benefits.

Benefits

Medical insurance

Dental insurance

Vision insurance

Life insurance

Disability insurance

Retirement plan

Flexible schedules

Paid time off

Dress flexibility

Qualifications

• 3 years experience in care management for Behavioral and Physical Health conditions.
• Active RN license in North Carolina required.

Responsibilities

• Support members transitioning from institutional care to community-based care.
• Conduct medication reviews and provide Physical Health education.

Skills

Communication

Problem-solving

Negotiation

Education

RN license

Master's degree in Occupational Therapy or Physical Therapy

Tools

Microsoft Office

Job description

Care Management Consultant - (RN), (PT), or (OT), Licensed Candidates Encouraged to Apply, (Full-Time Remote, North Carolina Based) (Healthcare)

The Care Management Consultant is a highly trained and experienced Clinician working in a consultative role and providing secondary Case Management as part of Alliance's Multidisciplinary Care Management Team for members with Physical Health needs. The Care Management Consultant offers on-demand recommendations, provides Physical Health-related education within their scope of licensure, completes Medication Reviews, and escalates review of complex cases to Medical Directors and/or Pharmacists as necessary to optimize health outcomes for the member.

This is a full-time Remote position. There is no expectation of coming into the office routinely; however, the selected candidate must be available to report onsite to the Alliance Office if needed to attend business meetings.

Responsibilities & Duties

• Support members transitioning from institutional care settings to community-based care
• Provide subject matter expertise, within scope, regarding member's physical and/or behavioral health to support the development and delivery of a whole person approach to Care Management
• Work collaboratively with other Alliance staff, behavioral health providers, primary care physicians, specialty care providers, and other community partners and stakeholders to support members in their home communities

Complete Assessments and Planning

• Utilize person-centered planning, motivational interviewing, and assessments to gather information and care planning
• Address concerns and/or questions from internal CM staff about the physical health/treatment/medications for our members
• Educate team members about the impact of members' health conditions on service engagement, clinical outcomes, and prognosis
• Actively collaborate with the member and care team members to ensure the care plan accurately reflects the individual's clinical needs and life goals
• Collaborate with internal Care Management staff and provide consultation regarding members with specialized physical health needs, transitions between care settings, and physical health needs identified via assessments and care plan generation
• Provide medication reconciliation and education
• Consult with Pharmacy Team for Polypharmacy concerns as appropriate
• Provide Physical Health Consultation to internal Care Management team members for questions related to member's Physical Health (e.g., CHF, Diabetes)

Medication Management

• Process and prioritize referrals from Care Management staff to ensure medication reconciliation is completed
• Contact members and/or guardians via phone or email to schedule medication review appointments
• Review members' medical history to identify risk factors including recent hospitalizations, ER visits, multiple physicians, polypharmacy, or new diagnoses
• Connect with members at scheduled appointments via telephone or virtually
• Review and address medication adherence barriers
• Consult and escalate cases to Alliance's Pharmacy team as per standard procedures

Documentation

• Ensure all clinical documentation (goals, plans, progress notes, etc.) meet state, agency, and Medicaid requirements
• Follow administrative procedures and effectively manage caseloads

Data

• Review, validate, and interpret risk stratification data and population health groups; recommend adjustments to care management approaches as needed
• Use data to analyze member needs, guide staff training, identify resource needs, and ensure workflow consistency across disciplines

Minimum Requirements

Education & Experience

Graduation from an accredited nursing school with three (3) years of full-time, post-degree experience in care management, case management, or care coordination for members with Behavioral and Physical Health conditions. Must hold an active, valid RN license in North Carolina.

Or

Master's degree in Occupational Therapy or Physical Therapy from an accredited institution, with two (2) years of full-time, post-master's experience in care management, case management, or care coordination for similar members. Must hold an active, valid OT or PT license in North Carolina.

Knowledge, Skills, & Abilities

• Knowledge of assessment and treatment of mental health, substance abuse, intellectual, and developmental disabilities
• Knowledge of legal, waiver, accreditation standards, and program practices/requirements
• Knowledge of the Alliance Health service benefit plans and network providers
• Person-centered thinking and planning skills
• Detail-oriented with ability to organize multiple tasks and manage caseloads effectively under deadlines
• Exceptional interpersonal and communication skills
• Ability to make prompt, independent decisions based on relevant facts and established processes
• Problem-solving, negotiation, and conflict resolution skills
• Proficiency in Microsoft Office (Word, Excel, Outlook, etc.)

Salary Range

$66,240 - $84,456 annually; actual salary based on education, experience, market data, and internal equity

Includes benefits such as medical, dental, vision, life, disability insurance, retirement plan, flexible schedules, paid time off, and dress flexibility.

Additional Information

Learn more about working with us: https://youtu.be/1GZOBFx61QU

Education (Preferred)

• Associates or better in Nursing

Licenses & Certifications (Required)

• Driver License

Equal Opportunity Employer. For more details, review the "Know Your Rights" notice from the Department of Labor.