Care Manager
Vaya Health
TCM Care Manager
HealthKeeperz
full-time
Posted on:
Origin: • 🇺🇸 United States • North Carolina
Visit company websiteSalary
💰 $25 per hour
Job Level
JuniorMid-Level
About the role
- Conduct comprehensive assessments at enrollment, yearly, or during changes in condition
- Develop, update, and facilitate Care Plans derived from assessments
- Utilize person-centered planning, motivational interviewing, and historical review of assessments to identify required supports
- Address Social Determinants of Health (SDOH), disparities, and complex payer issues in the Plan of Care
- Assign interventions/plans of care to Extenders for monitoring and service engagement
- Coordinate with team members for smooth transitions to appropriate levels of care and utilize ADT information to support admissions/transfers/discharges
- Participate in the agency’s twenty-four (24) hour coverage for care management
- Educate members/Legally Responsible Persons about care teams, services, rights, grievance and appeals process, service options, and payer requirements
- Promote customer satisfaction through ongoing communication and timely follow-up
- Ensure adherence to service orders/doctor’s orders, obtain necessary releases/documentation, and submit documentation to payer
- Maintain certifications/licensure and comply with agency policies and procedures
- Evaluate appropriateness of services, implement plan of care through regular assessments, escalate complex cases and report critical incidents
- Attend Behavior Support Plan (BSP) meetings
- Assist individuals/Legally Responsible Persons in choosing service providers objectively
- Collaborate with care team and service providers to develop plans reflecting individual needs and life goals
- Visit members at their living arrangements (home, relative's home, care facility, or other locations) as required
- Report to Tailored Care Management Supervisor and work as part of a multidisciplinary care team providing whole-person care management for Behavioral Health I/DD Tailored Plan beneficiaries
Requirements
- A Bachelor’s degree in a field related to health, psychology, sociology, social work, nursing or licensure as a registered nurse (RN)
- Two years of experience working directly with individuals with behavioral health conditions, I/DD or TBI condition(s)
- For Care managers serving members with LTSS needs: two years of prior LTSS and/or HCBS coordination, care delivery monitoring, and care management experience
- Proficiency in Person-Centered Thinking/planning
- Experience using assessments to develop plans of care
- Knowledge of LOC processes
- Familiarity with Medicaid basic, enhanced MHSUD, and waiver benefits plans
- Proficiency in using Motivational Interviewing techniques
- Strong interpersonal and written/verbal communication skills
- Conflict management and resolution skills
- Proficiency in Microsoft Office products
- Ability to make prompt, independent decisions
- Good organizational skills to prioritize duties and meet deadlines
- Maintain all certifications or licensure required for the position and comply with agency policies
- Ability to visit members in their living arrangements and perform driving and other physical activities as required
