Care Manager

ADP, Inc.; Cary (NC); Hybrid; USD 60,000 - 80,000; Full time

Job summary

Community Care of North Carolina (CCNC) is seeking a Care Manager in Cary, NC. The role entails coordinating a full continuum of health care services, collaborating with care teams, and ensuring population health outcomes across a statewide network.

The ideal candidate will work within RN or social work scopes and may operate remotely within regions to cover statewide needs. The position emphasizes patient-centered care, privacy compliance, and ongoing professional development, with travel

Qualifications

• RN or MSW licensed in NC.
• CCM cert preferred; within 1 year of eligibility.

Responsibilities

• Provide care management per standards for enrolled populations.
• Conduct member assessments across medical, biopsychosocial needs.
• Identify barriers and strengths impacting care and treatment.
• Educate members and families on diagnosis, meds, resources, prevention.
• Set SMART goals with members and families; monitor progress.
• Coordinate member care plans with the care team and providers.

Skills

RN licence

LCSW

CCM

EMR access

Education

BSN preferred

RN license NC

Tools

EMR system

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Care Manager

Full Time Cary, NC, US 1 Attachments

30+ days ago Requisition ID: 1768

CCNC's Mission Statement:

To improve the health and quality of life for all North Carolinians by building supporting better community-based healthcare delivery systems.

Value Proposition:

From the mountains to the coast, from large cities to small towns, Community Care of North Carolina is transforming health care. Informed by statewide data and predictive analytics, community-based care-managers work with local physicians and diverse teams of health professionals to develop whole-person plans of care that connect people to the right local resources and increase equity and access to high quality care. We advance patient-centered practice models and connect different segments of the local health systems. This proven population health management approach delivers better health outcomes, at lower costs, to communities across North Carolina, including those that experience the greatest health disparities. Through these activities, CCNC and Community Care Physician Network help practices thrive financially, provide high value care, maximize provider satisfaction, and take charge of their own destinies.

At CCNC, we help some of the state's most vulnerable patients navigate the healthcare system and manage their conditions through the collaborative efforts of care teams deeply committed to meeting their needs. Please see the attachment and check out our website for a full list of benefits offered: https://www.communitycarenc.org/careers

Position Summary

Address the needs of the population served by assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required by using communication and available resources to promote quality, cost-effective health outcomes.

Performing within the Registered Nurse and/or Licensed Clinical Social Work scope of practice, collaborate with the Primary Care Provider, member, guardian, caregivers, family members, other members of the Care Management Team, and the community to coordinate a full continuum of health care services. Holistic needs of the member, inclusive of unique social and cultural dynamics should be considered. The Care Manager may work remotely within regions to cover the needs across the state.

Essential Functions

• Provide effective Care Management services based on case management standards of practice to enrolled populations.
• Complete member assessments considering the total individual, inclusive of medical, biopsychosocial, behavioral, spiritual, and cultural needs to enrolled population, throughout the continuum of care.
• Work with members to identify and address behavioral, social, cultural, and environmental strengths and barriers as it relates to his/her diagnosis, treatment, and access to care.
• Provide education to member/family about clinical diagnosis, medications, available resources, prevention, and risk factors to achieve optimal self-management.
• Monitor quality and effectiveness of interventions to the enrolled populations by setting patient-centered SMART goals in collaboration with the members/families.
• Develop, review, implement, and evaluate the member care plan in partnership with the member, caregiver/guardian/family members, providers, and Care Management team members, as applicable.
• Incorporate therapeutic skills and techniques such as trauma-informed care, motivational interviewing, strengths-based, and solution-focused modalities to help members achieve healing, growth, health, and wellness.
• Utilize Hospital/Data or Electronic Medical Record system as available.
• Per guidance, facilitate referrals for members/families to appropriate community-based services and agencies.
• Refer to appropriate clinical team members for interventions which are outside the Care Managers’ scope of practice and/or expertise.
• Work collaboratively with multi-disciplinary team members to facilitate achievement of desired treatment outcomes.
• Engage and maintain collaborative relationships with community provider agencies that promote quality care and cost-effective health care utilization.
• Serve as a liaison among the member/family/guardian, community services, primary providers, specialists, and other care team members to coordinate services without duplication.
• Respect member’s values, experience, and help to empower members to be an advocate for their own care.
• Maintain appropriate member documentation in the Care Management documentation platform, in accordance with organizational policies and procedures.
• Meet monthly productivity and role expectations.
• Understand, uphold, and abide by CCNC company and department policies, goals, standards, and objectives.
• Adhere to CCNC privacy, security policies, and HIPAA regulations to ensure that patient and company data are properly safeguarded.
• Attend departmental and corporate meetings, local and regional training, or other events as required.
• Travel using personal vehicle will be required within the region and/or the State.
• Perform all other duties as requested.

Qualifications

Registered Nurse (RN)

• Graduation from an accredited school of nursing
• BSN preferred
• Active, unrestricted RN license to practice in North Carolina
• Minimum 2 years’ nursing experience; 1-year care management or community-based nursing preferred
• CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements
• Meets licensure or educational eligibility requirements as determined by The Commission for Case Management Certification
• Access to Hospital/Data or Electronic Medical Record system will be required, as necessary
• Maintain a valid driver’s license with current auto liability insurance

OR

Social Worker

• Master’s degree from an accredited school of social work
• Minimum 2 years’ social work experience; 1-year case management or community-based social work preferred
• Active NC license as a Licensed Clinical Social Worker (LCSW)
• CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements
• Meets licensure or educational eligibility requirements as determined by The Commission for Case Management Certification
• Access to Hospital/Data or Electronic Medical Record system will be required, as necessary
• Maintain a valid driver’s license with current auto liability insurance

Knowledge, Skills, and Abilities

• Computer skills required including various office software and the internet; experience with MS Office software preferred
• Excellent communication skills – oral and written; Bilingual preferred
• Knowledge of government, private sector, and community resources
• Knowledge of Case Management principles
• Knowledge of and compliance with federal and state regulations applicable to the position
• Strong organizational and time management skills
• Skills in establishing rapport with a member and applying techniques of assessing comprehensive health care needs
• Critical thinking skills, effective clinical judgment, independent decision-making, and problem-solving abilities
• Sensitivity to diversity of cultures, language barriers, health literacy, and educational levels
• Ability to work independently and function as an integral part of a multi-disciplinary team
• Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives
• Able to shift strategy or approach in response to the demands of a situation

Working Conditions

• The job environment is primarily an office or home environment
• Multiple contacts, face to face and/or telephonic, are required with various members, providers, multi-payer systems and community partners to ensure coordination of services; exposure to general office and household conditions, as well as communicable disease could occur
• Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time
• Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices
• Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds
• Travel will be required within the region and/or the State