Special Programs Case Manager Lead (1915i/IDD Team)

Elevance Health, Inc.; Winston-Salem (NC); Hybride; USD 90 000 - 120 000; Plein temps

Résumé du poste

Elevance Health seeks a Special Programs Case Manager Lead in North Carolina, requiring residency in-state. The role coordinates case management for specialty programs, serving as a coach to case managers and leading operational workflows across field sites with occasional in-office meetings.

Responsibilities include telephonic and home-visit case management within licensure, managing costs via integrated care, and ensuring whole-person health.

Qualifications

• MS/MA in social work, counseling, or related behavioral health field; or nursing degree with 7+ years of clinical experience.
• Active license as RN, LCSW, LMHC, LPC, LMFT, or Clinical Psychologist required to practice in applicable states.

Responsabilités

• Coordinate operations and workflows for case management in specialty programs (e.g., Foster Care).
• Serve as coach and mentor to Special Programs case managers.
• Conduct case management telephonically and/or via home visits within licensure scope.
• Manage overall healthcare costs for designated populations through integrated physical and behavioral health care.

Connaissances

Leadership

Coaching

Field-based

Formation

MS/MA in social work or nursing degree

Active professional license (RN/LCSW/LMHC/LPC/LMFT/Clinical Psychologist)

Description du poste

Special Programs Case Manager Lead

North Carolina residency is required!

Location: State of North Carolina

Field: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands‑on engagement. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The Special Programs Case Manager Lead is responsible for coordinating operations and workflows related to case management activities in support of specialty programs, such as Foster Care. Serves as coach. Performs case management telephonically and/or by home visits within the scope of licensure. Manages overall healthcare costs for the designated population via integrated (physical health/behavioral health) case management and whole person health. Manages the most complex cases and provides support to Special Programs case managers.

How you will make an impact

• Conducts assessments to identify individual needs.
• Develops comprehensive care plan to address objectives and goals as identified during assessment. Supports member access to appropriate quality and cost effective care and modifies plan(s) as needed.
• Coordinates with internal and external resources to meet identified needs of the member in terms of integrated (physical and behavioral) whole person care.
• Coordinates social determinants of health to meet the needs of the member and incorporates that into care planning.
• Works closely with various state agencies.
• Maintains knowledge of the system of care philosophy; a spectrum of effective, community-based services and supports for those with or at risk for mental health or other challenges and their families, that is organized into a coordinated network.
• Builds meaningful partnerships with designated populations and their families, and addresses cultural and linguistic needs, in order to help them function better at home, in the community, and throughout life.
• Evaluates health needs and identifies applicable services and resources in conjunction with members and their families.
• Provides important information including patient education, medication reconciliation, and identification of community resources and assists with arrangement of follow-up care.
• Facilitates health rounds with other clinical centered professionals to ensure whole person health.
• May lead and work on specialty projects and initiatives.
• Assists with process improvements activities.
• Trains and mentors staff. Performs case/chart audits and ensures departmental compliance.
• Serves as a member of the leadership team.

Minimum requirements

• Requires MS/MA in social work, counseling, or a related behavioral health field or a degree in nursing and minimum of 7 years of clinical experience in social work counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background.
• Requires an active, current and valid license as an RN, LCSW (as applicable by state law and scope of practice), LMHC, LPC (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.

Preferred Skills, Capabilities and Experiences

• Experience working with specialty populations preferred.
• Clinical experience in social work counseling with a broad range of complex psychiatric/substance abuse and/or medical disorders preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.