Care Manager I – TCL

Jobtailor; Charlotte (NC); On-site; USD 52,000 - 76,000; Full time

Job summary

Alliance Health Plan seeks Care Manager professionals to coordinate comprehensive, integrated care for individuals with special health care needs in North Carolina. You will conduct assessments, develop care plans, and educate members and guardians about available services and care teams.

Responsibilities include coordinating across health and social services, assigning interventions, and ensuring timely referrals for complex medical or behavioral health needs.

Qualifications

• Bachelor’s degree from an accredited college or university in Human Services field with 2 years post-bachelor mh/dd/sa experience.
• Or Bachelor’s degree in Non‑Human Services field with 4 years post-bachelor mh/dd/sa experience.
• Or Master’s Degree in Human Services with 1 year post graduate mh/dd/sa experience.
• Or NC license as LCSW, LCMHC, LPA, or LMFT.
• Or NC RN with 4 years mh/dd/sa experience.

Responsibilities

• Coordinate integrated care across physical health, behavioral health, pharmacy, and unmet health-related resource needs.
• Develop Plans of Care from assessments.
• Schedule and conduct education with member/guardian about care teams and services.
• Assign interventions to team members and monitor engagement.
• Submit referrals for medical/pharmaceutical complexity when indicated.
• Complete comprehensive assessments at enrollment and changes in condition.

Skills

Person Centered Thinking

Assessment planning

DSM knowledge

Medicaid/waiver knowledge

Microsoft Office

Interpersonal communication

Conflict resolution

Decision making

Education

Bachelor's degree in Human Services or related field

Master’s degree in Human Services (preferred)

Licensed in NC (LCSW/LCMHC/LPA/LMFT) or RN (NC)

Tools

Microsoft Office

Job description

Responsibilities

• The Care Manager l‑TCL assures that individuals and families with special health care needs receive integrated whole‑person care management, including coordinating across physical health, behavioral health, pharmacy and unmet health‑related resource needs to ensure they are linked to services and supports in an effort to maximize potential outcomes and decrease the unnecessary use of hospitals and emergency services by assuring that appropriate quality care is in place.
• The Care Manager I – TCL focuses on a specified population of members utilizing health care services while ensuring all member health needs and referrals are attended to.
• The Care Manager l will collaborate with other community systems to work in partnership to support the identified population while working to assist member with remaining in their preferred housing per Transition to Community Living requirements.
• Complete comprehensive assessments or Care Needs Screening at enrollment, yearly or at changes in condition.
• Develop Plans of Care derived from the completed assessments.
• Demonstrate commitment to whole person/integrated care.
• Assign interventions/plans of care to applicable Alliance Care Management team member to meet identified member needs, for monitoring, and/or service engagement activities.
• Submit referrals to the CCM when a physical health or behavioral health need indicates medical and/or pharmaceutical complexity.
• Schedule initial contact with member for purpose of assessment and engagement.
• Schedule face to face, virtual, and telephonic meeting with member/guardian to provide education about Alliance Health Plan, care teams, resources, and services.

Qualifications

• Bachelor’s degree from an accredited college or university in Human Services field and two (2) years of post‑bachelor’s degree mh/dd/sa experience with the population served.
• Or Bachelor’s degree from an accredited college or university in Non‑Human Services field and four (4) years of post‑bachelor’s degree mh/dd/sa experience with the population served.
• Or Master’s Degree from an accredited college or university in Human Services field and one (1) year of post graduate degree mh/dd/sa experience with the population served.
• Or Fully or Provisionally Licensed in the State of North Carolina as a LCSW, LCMHC, LPA, or LMFT.
• Or Licensed Registered Nurse (RN) in the State of North Carolina with four (4) years of mh/dd/sa experience with the population served.
• Preferred: NACCM, NADD‑Specialist and/or CBIS Certification.
• Knowledge, Skills, & Abilities Person Centered Thinking/planning.
• Knowledge of using assessments to develop plans of care.
• Knowledge of Diagnostic and Statistical Manual of Mental Disorders.
• Knowledge of LOC process, SIS for IDD and FASN assessment for TBI.
• Knowledge of Medicaid Tailored Plan, Medicaid Direct, enhanced MHSUD, and waiver benefits plans.
• Knowledge of and skilled in the use of Motivational Interviewing.
• Proficient in Microsoft Office products (such as Word, Excel, Outlook, etc.).
• Strong interpersonal and written/verbal communication skills essential, including Conflict management and resolution skills.
• High level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance.
• Ability to make prompt, independent decisions based upon relevant facts.