Care Manager

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Evaluate, plan, implement, coordinate, monitor, and assess options and services to enhance quality and cost-effective health outcomes.

• Deliver effective Care Management services adhering to case management standards of practice.

• Conduct thorough medical, biopsychosocial, behavioral, spiritual, and cultural assessments of members.

• Identify and address strengths and barriers related to behavioral, social, cultural, and environmental factors.

• Educate members and their families about diagnoses, medications, resources, prevention strategies, and risk factors.

• Establish patient-centered SMART goals and evaluate the quality and effectiveness of interventions.

• Create, review, implement, and assess member care plans in collaboration with members, families, providers, and the Care Management team.

• Apply trauma-informed care, motivational interviewing, strengths-based, and solution-focused techniques.

• Utilize Hospital/Data or Electronic Medical Record systems as available.

• Facilitate referrals to suitable community-based services and agencies.

• Refer issues beyond the Care Manager’s expertise to the appropriate clinical team members.

• Collaborate with multidisciplinary teams to achieve desired treatment outcomes.

• Maintain relationships with community provider agencies to ensure quality and cost-effective care.

• Coordinate services among members, families, guardians, providers, specialists, community services, and care team members.

• Keep member documentation in the Care Management documentation platform updated.

• Meet monthly productivity and role expectations.

• Comply with CCNC policies, privacy, security policies, and HIPAA regulations.

• Attend departmental and corporate meetings, training sessions, and required events.

• Travel within the assigned region and/or statewide.

• Perform additional duties as requested.

⛳️ Requirements

• Registered Nurse (RN): Graduation from an accredited nursing school.

• Registered Nurse (RN): Active, unrestricted RN license to practice in North Carolina.

• Registered Nurse (RN): A minimum of 2 years of nursing experience.

• Social Worker: Master’s degree from an accredited school of social work.

• Social Worker: At least 2 years of social work experience.

• Social Worker: Active NC license as a Licensed Clinical Social Worker (LCSW).

• CCM certification preferred; must obtain within 1 year of eligibility according to CCM requirements.

• Must meet licensure or educational eligibility criteria as determined by The Commission for Case Management Certification.

• Access to Hospital/Data or Electronic Medical Record systems will be required as needed.

• Maintain a valid driver's license with current auto liability insurance.

• Proficient computer skills are required, including familiarity with various office software and the internet.

• Knowledge of government, private sector, and community resources.

• Understanding of Case Management principles.

• Familiarity with and adherence to federal and state regulations relevant to the position.

• Strong organizational and time management skills.

• Ability to establish rapport with members and assess comprehensive healthcare needs.

• Critical thinking, effective clinical judgment, independent decision-making, and problem-solving skills.

• Capability to work independently and be an integral part of a multidisciplinary team.

• Must be able to use office equipment, computer, keyboard, and phone with or without assistive devices.

• Involves repetitive wrist motion and occasional lifting or carrying of up to 25 pounds.

🏝️ Benefits

• Remote work opportunities within assigned regions.

• Travel using a personal vehicle within the region and/or statewide.

• Opportunities for professional development through local and regional training.

• Support for CCM certification: must be obtained within 1 year of eligibility per CCM requirements.