Care Manager

Community Care of North Carolina; Cary (NC); Remote; USD 65,000 - 90,000; Full time

Job summary

Community Care of North Carolina seeks an experienced Care Manager (RN or Social Worker) to assess, plan, coordinate, and evaluate health services for enrolled populations. You will collaborate with primary care providers and care teams, applying evidence-based case management to promote quality and cost-effective outcomes, with remote regional coverage across the state.

The role requires strong communication, trauma-informed approaches, and EMR proficiency.

Qualifications

• RN with NC license required; BSN preferred.
• MSW with NC LCSW license required; CCM preferred within 1 year of eligibility.
• Minimum 2 years’ nursing or social work experience; case management or community-based care preferred.
• CCM certification preferred; will obtain within 1 year of eligibility.
• Access to Hospital/Data or Electronic Medical Record system required.

Responsibilities

• Provide effective Care Management services based on case management standards of practice.
• Complete member assessments considering medical, biopsychosocial, behavioral, spiritual, and cultural needs.
• Identify and address barriers related to diagnosis, treatment, and access to care.
• Educate member/family about diagnosis, medications, resources, prevention, and risk factors.
• Monitor interventions by setting patient-centered SMART goals with members/families.
• Develop and evaluate the member care plan with the care team and family.

Skills

Communication skills

Bilingual preferred

Case management

Independent decision-making

Collaboration

Education

BSN preferred

MSW degree

Tools

EMR system access

Job description

About CCNC

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.

CCNC Mission Statement

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

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.

Care Manager(s) will serve the population within regions 2, 4, and 6. Remote and travel will be required within the region and/or the State. Preferred to reside in the following Counties: Guilford, Alamance, and Randolph.

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

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