TCM Care Manager
HealthKeeperz
full-time
Posted on:
Location Type: Hybrid
Location: Wilmington • North Carolina • United States
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Salary
💰 $53,000 per year
About the role
- Conduct comprehensive assessments at enrollment, yearly, or during changes in condition.
- Develop, update, and facilitate Care Plans derived from these 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.
- Participate in the agency’s twenty-four (24) hour coverage for care management.
- Educate members/Legally Responsible Persons (LRP) about care teams, services, rights, the grievance and appeals process, available service options, and payer requirements.
- Promote customer satisfaction through ongoing communication and timely follow-up on any concerns/issues.
- Ensure adherence to service orders/doctor’s orders and obtain necessary releases/documentation.
- Submit necessary documentation to the payer for timely service delivery.
- Maintain all certifications or licensure required for the position and comply with all agency policies and procedures.
- Evaluate the appropriateness of services and ensure the implementation of the plan of care through regular assessments.
- Escalate complex cases to the Supervisor and report critical incidents.
- Attend Behavior Support Plan (BSP) meetings.
- Assist individuals/LRP in choosing service providers, ensuring objectivity.
- Utilize Admission, Discharge, and Transfer (ADT) information to support members admitted, transferred, or discharged from a facility promptly.
- Collaborate with the care team and service providers to develop plans reflecting the individual’s needs and desired life goals.
- Complete all other responsibilities as assigned by the supervisor.
- Visiting members at their living arrangements, such as their own home, a relative's home, a care facility, or any other location, is essential and required to ensure the delivery of high-quality care.
Requirements
- A Bachelor’s degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area, 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.
Benefits
- Flexible work arrangements
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
person-centered planningmotivational interviewingassessmentscare plansLTSS coordinationHCBS coordinationbehavioral health conditionsI/DDTBILOC processes
Soft Skills
interpersonal communicationwritten communicationverbal communicationconflict managementconflict resolutionorganizational skillsdecision makingcustomer satisfactionteam collaborationeducation
Certifications
Bachelor’s degree in health-related fieldlicensure as a registered nurse (RN)