Tailored Care Manager

General Statement of Job:

This Care Manager is responsible for providing treatment planning case management to individuals having a primary diagnosis / disability of Mental Health, Substance Use and/or I/DD. This position requires a proactive approach to assessment, monitoring and coordination of care to ensure quality and consistence requirement. This is a hybrid/remote position with work done at multiple locations. The Care Manager will spend a considerable amount of time in the field and completes required documentation through consumers treatment from intake to discharge.

Qualification and Education Requirements:

• A Bachelor’s degree in Special Education, Psychology, Social Work, Human Services.

• 2 Years of post-degree professional experience.

• Must qualify as a Qualified Professional for per 10A-NCAC 27G .0104 with experience related to the population assigned.

• Works within the established ethical and HIPPA law, the Confidential Alcohol and Substance Abuse Patient Records law.

• The individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his / her capacity as an employee of Selfless Foundation.

• The individual filling this position shall also sign a confidentially statement as an employee of Selfless Foundation.

• Two years prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience, for those serving members with LTSS needs.

Essential Job Functions:

• Utilizes person centered planning methods and strategies to gather information and to get to know the individuals supported.

• Provides education and support to individuals in learning about exercising rights.

• Completes discovery activities (information gathering and assessment) in advance of planning meetings.

• Ensures that individuals or legally responsible persons regarding their choice in choosing service providers, ensuring objectivity in the process.

• Assists the individual supported to direct the planning process and plan development, to the extent desired by the individual.

• Facilitates and coordinates timely development of the Individual Support Plan, Crisis plan and Behavior Support Plan.

• Participates in crisis intervention and planning. May include nights and weekend phone calls as well as collaboration with Mobile Crisis teams.

• Collaborates with individuals supported and members of the treatment team to ensure development of an Individual Service Plan that is comprehensive and reflects the individual’s needs and desired life goals.

• Promotes use of natural / community resources through the assessment and planning process.

• Ensures that assessment and plans are updated whenever the individual life circumstances change.

• Monitors quality care, health and safety of the individual as well as the continue appropriateness of services.

• Ensures that services are monitored to include direct observation of service delivery in all settings.

• Makes announced / unannounced monitoring visits, including nights /weekends.

• Monitors services for compliance with state standards, waiver requirements, and Medicaid regulations.

• Promotes problem – solving and goal –oriented partnership with individuals and legally responsible person, and providers. Recognizes and reports critical incidents.

• Promotes satisfaction through ongoing communication and timely follow-up on any concerns and/ or issues.

• Promotes satisfaction through ongoing communication and timely follow-up on any concerns and / or issues.

• Educates individuals and families on methodology for budget development, total dollar value of the budget and mechanisms available to modify the individual budget.

• Verifies that services are delivered as outlined in the Individual Support Plan and addresses any deviations in service. Ensures that service orders and doctor’s orders are obtained.

• Work with Eligibility and Enrollment Department to ensure verification of an individual’s continuing eligibility for Medicaid

• Proactively responds to an individual’s planned movement outside the Selfless Foundation geographic area to ensure changes in their Medicaid County of eligibility are addressed prior to any loss of service.

• Coordinates Medicaid deductibles, with the individual and legally responsible person and providers.

• Proactively monitors own documentation to ensure that issues and errors are resolved as quickly as possible.

• Ensures accurate and timely submission of Service Authorization Requests for all Selfless funded services and supports.

• Ensures all clinical documentation ( e.g. goals, plans, progress notes,) meet state agency and Medicaid requirements.

• Maintains administrative record compliance / quality, as demonstrated by > 95% compliance on Qualitative Record Reviews / Chart Audits.

• Provides direct supervision to Tailored Care Manager Extenders.

• Facilitate Treatment Team Meetings.

The minimum contact requirements will be as follows:

Care manager contacts for members with behavioral health needs:

• At least 4 hours of contact per month

• 1 face-to-face contact every 60 days

Knowledge, Skills and Abilities:

A demonstrated knowledge of the assessment and treatment of developmental disabilities, with or without co-occurring mental illness, is a necessity. Employee will participate in and maintain Care Coordination and Selfless Foundation trainings is required.

This position requires exceptional interpersonal skills, highly effective communication ability, and the ability to make prompt independent decisions based on relevant facts and established processes. Problem solving, negotiation and conflict resolution skills are essential to balance the needs of internal and external customers.

Residency Requirement:

In accordance with the Tailored Plan requirements mandated by the North Carolina Department of Health and Human Services, Selfless Foundation health positions are required to be filled by individuals who reside in North Carolina, meaning someone who establishes a legal domicile in North Carolina and pays income tax in North Carolina, or resides within 40 miles of the North Carolina border. New hires from outside of North Carolina will have 60 days from the date of hire to meet this requirement, if applicable to the position.

Job Type: Full-time

Pay: $50,000.00 - $60,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Ability to Commute:

• Greensboro, NC 27407 (Required)

Ability to Relocate:

• Greensboro, NC 27407: Relocate before starting work (Required)

Willingness to travel:

• 25% (Required)

Work Location: In person

Salary : $50,000 - $60,000