Innovations Care Manager (McDowell & Rutherford County, NC)

Vaya Health; Spindale (NC); Remote; USD 45,000 - 70,000; Full time

Job summary

Ein innovatives Unternehmen sucht einen Innovations Care Manager, der für die proaktive Intervention und Koordination der Pflege verantwortlich ist. Diese Rolle erfordert die Zusammenarbeit mit Mitgliedern und Pflege-Teams, um Versorgungslücken in verschiedenen Gesundheitsbereichen zu schließen. Der Innovations CM wird in der Gemeinschaft arbeiten, um sicherzustellen, dass die Mitglieder die erforderlichen Dienstleistungen erhalten und ihre Bedürfnisse erfüllt werden. Wenn Sie eine Leidenschaft für die Verbesserung der Lebensqualität von Menschen mit besonderen Bedürfnissen haben und in einem dynamischen Umfeld arbeiten möchten, ist dies die perfekte Gelegenheit für Sie.

Qualifications

• Mindestens zwei Jahre Erfahrung in der Arbeit mit I/DD oder TBI-Populationen.
• Kenntnisse über NC Medicaid-Programme erforderlich.

Responsibilities

• Entwicklung und Umsetzung von personenzentrierten Pflegeplänen.
• Zusammenarbeit mit Mitgliedern und Anbietern zur Förderung der Versorgung.
• Überwachung der Dienstleistungsbereitstellung auf Qualität und Compliance.

Skills

Kommunikationsfähigkeiten

Beziehungsaufbau

Aufmerksamkeit für Details

Entscheidungsfindung

Microsoft Office

Kenntnisse in mentaler Gesundheit

Education

Bachelor-Abschluss in Gesundheitswesen

Lizenz als RN in NC

Tools

Vaya Care Management Software

Job description

LOCATION: Remote - must live in or near McDowell or Rutherford County, North Carolina. The person in this position is required to maintain residency in North Carolina or within 40 miles of the NC border. This position requires travel.

GENERAL STATEMENT OF JOB

The Innovations Care Manager (Innovations CM) is responsible for providing proactive intervention and care coordination to eligible Vaya Health members to ensure appropriate assessment and services. The Innovations CM collaborates with members and care teams to address care gaps across mental health, substance use, intellectual/developmental disabilities, traumatic brain injury, physical health, pharmacy, LTSS, and unmet resource needs. This role involves supporting transitions from facilities, tracking discharged individuals, and working in members' communities. It requires travel and collaboration with various stakeholders. Essential functions include:

1. Using Vaya's Care Management software and health records proficiently.
2. Engaging with members and providers to promote care.
3. Ensuring HIPAA compliance and proper information release.
4. Performing comprehensive health risk assessments addressing social determinants, health history, and needs.
5. Maintaining medication lists and continuity of care.
6. Participating in care planning and interdisciplinary team meetings.
7. Supporting transitional and diversion care efforts.

Residency Requirement: Must reside in North Carolina or within 40 miles of the NC border to effectively deliver in-person services.

ESSENTIAL JOB FUNCTIONS

Assessment, Care Planning, and Care Team Collaboration:

• Identify, assess, and develop person-centered care plans.
• Link members to appropriate services across health domains.
• Conduct HRAs and screenings, utilizing results for education and linkage.
• Support care team in developing and updating Care Plans, ensuring inclusion of member goals and needs.
• Review assessments, refine treatment goals, and address barriers.
• Inform members/LRPs about services and referral processes.
• Facilitate care team meetings and monitor progress.
• Update Care Plans annually or upon significant changes.
• Participate in multidisciplinary case reviews and crisis planning.

Support, Monitoring, Documentation, and Fiscal Accountability:

• Identify system barriers and collaborate with community stakeholders.
• Manage high-risk team meetings and participate in cross-functional projects.
• Monitor service delivery for quality and compliance.
• Ensure member eligibility and timely documentation within the health record.
• Coordinate Medicaid and other resource management tasks.
• Participate in required training and maintain proficiency.

Other duties as assigned.

KNOWLEDGE, SKILLS, & ABILITIES

• Clear communication skills and professional representation.
• Ability to build relationships and work independently.
• Attention to detail and organizational skills.
• Decision-making ability and result-oriented approach.
• Adaptability to changing demands.
• Proficiency in Microsoft Office and Vaya systems.
• Knowledge of mental health, substance use, I/DD, TBI services, and NC Medicaid programs.

EDUCATION & EXPERIENCE REQUIREMENTS

Bachelor's degree in health, psychology, sociology, social work, nursing, or related field. Experience requirements vary based on education and licensure, including at least two years working with I/DD or TBI populations and LTSS coordination. Licensure as an RN in NC is required if applicable. Must meet North Carolina Qualified Professional criteria.

PHYSICAL REQUIREMENTS

• Visual acuity, physical activity including walking, reaching, and sitting for extended periods.
• Ability to drive and work in various settings, including rural areas.

RESIDENCY: Must reside in North Carolina or within 40 miles of the NC border.

SALARY: Dependent on qualifications and experience. Non-exempt position eligible for overtime.

APPLICATION DEADLINE: Open Until Filled

HOW TO APPLY: Submit applications via our Career Center at https://www.vayahealth.com/about/careers/.

Vaya Health is an equal opportunity employer.