Care Manager I coordinating integrated whole-person care management at Alliance Health, focusing on members with special health care needs. Involves assessments and collaboration with community systems.
Responsibilities
Complete comprehensive assessments or Care Needs Screening at enrollment, yearly or at changes in condition.
Develop Plans of Care derived from the completed assessments
Demonstrate commitment to whole person/integrated care
Assign interventions/plans of care to applicable Alliance Care Management team member to meet identified member needs, for monitoring, and/or service engagement activities
Submit referrals to the Transition Coordinator when a physical health or behavioral health need indicates medical and/or pharmaceutical complexity
Assign Plan of Care activities to Community Health Worker if member has identified Social Determinants of Health (SDOH), disparities and/or complex payer issues
Assist individuals/legally responsible persons in choosing service providers; ensuring objectivity in the process
Consistently evaluate appropriateness of services and ensure implementation of plan of care through information gathering and assessment at defined frequency of contact based on risk stratification
Utilize person centered planning, motivational interviewing, and historical review of assessments in Jiva to gather information and to identify supports needed for the individual
Assist in collecting data to be used to identify and address barriers as well as determine the effectiveness of care management/care coordination in reducing lengths of stay and use of emergency services
Actively collaborate with members/legally responsible person, care team, service providers, and identified supports to ensure development of a plan that accurately reflects the individual’s needs and desired life goals
Submit required documentation to UM to ensure timely delivery of services and trouble shoot until authorization is obtained.
Requirements
Bachelor’s degree from an accredited college or university in Human Services field and two (2) years of post-bachelor’s degree mh/dd/sa experience with the population served
Or Bachelor’s degree from an accredited college or university in Non-Human Services field and four (4) years of post-bachelor’s degree mh/dd/sa experience with the population served
Or Master’s Degree from an accredited college or university in Human Services field and one (1) year of post graduate degree mh/dd/sa experience with the population served
Or Fully or Provisionally Licensed in the State of North Carolina as a LCSW, LCMHC, LPA, or LMFT
Or Licensed Registered Nurse (RN) in the State of North Carolina with four (4) years of mh/dd/sa experience with the population served
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