Care Manager I – Waiver

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

📋 Description

• Deliver integrated, whole-person, and person-centered care management for individuals and families with specific health care needs.

• Coordinate physical health, behavioral health, pharmacy, and unmet health-related resource requirements.

• Perform comprehensive assessments and screenings for care needs.

• Create, assign, monitor, and update Plans of Care and Individual Service Plans.

• Facilitate referrals, authorizations, services, providers, community systems, and internal care team members.

• Educate members and legally responsible individuals about their rights, grievances, appeals, service options, and payer requirements.

• Arrange and conduct face-to-face, virtual, and telephonic meetings with members.

• Oversee service adherence, utilization, documentation, health status, progress, and individual goals.

• Identify barriers to treatment and services and assist with appointments and provider connections.

• Coordinate SIS assessments, facility discharges, ISP meetings, waiver services, HCBS placements, purchase orders, and transitions.

• Carry out required in-person field-based service observations for Medicaid C services.

• Engage with providers to address service delivery and administrative obstacles.

• Obtain, upload, maintain, and share necessary documentation and releases.

• Document updates and activities of members in JIVA and ensure compliance with medical records.

• Escalate complex cases and concerns to supervisors.

• Report critical incidents, provider quality issues, and changes in member health status.

• Travel to offices, member residences, provider locations, stakeholder meetings, court hearings, and Alliance-sponsored events as necessary.

• Ensure adherence to Alliance policies, procedures, state standards, and Medicaid requirements.

⛳️ Requirements

• Bachelor’s degree from an accredited college or university in a Human Services field with two (2) years of post-bachelor’s degree experience in mental health, developmental disabilities, or substance abuse with the served population, including two (2) years of coordination in LTSS and/or HCBS, care delivery monitoring, and care management experience; OR

• Bachelor’s degree in a Non-Human Services field and four (4) years of post-bachelor’s degree experience in mental health, developmental disabilities, or substance abuse with the served population, including two (2) years of coordination in LTSS and/or HCBS, care delivery monitoring, and care management experience; OR

• Master’s Degree in a Human Services field with one (1) year of post-graduate degree experience in mental health, developmental disabilities, or substance abuse with the served population, including two (2) years of coordination in LTSS and/or HCBS, care delivery monitoring, and care management experience; OR

• Fully or Provisionally Licensed in North Carolina as a LCSW, LCMHC, LPA, or LMFT with two (2) years of coordination in LTSS and/or HCBS, care delivery monitoring, and care management experience; OR

• Licensed Registered Nurse (RN) in North Carolina with four (4) years of experience in mental health, developmental disabilities, or substance abuse with the served population, including two (2) years of coordination in LTSS and/or HCBS, care delivery monitoring, and care management experience.

• Preferred: NACCM, NADD-Specialist and/or CBIS Certification.

• Knowledgeable in person-centered thinking/planning, assessments, plans of care, LOC process, SIS for IDD, FASN assessment for TBI, Medicaid benefits, and waiver plans.

• Proficient in Motivational Interviewing techniques.

• Excellent interpersonal and written/verbal communication skills.

• Skilled in conflict management and resolution.

• Proficient in Microsoft Office applications, including Word, Excel, and Outlook.

• High level of diplomacy and discretion.

• Ability to make prompt, independent decisions based on relevant information.

• Satisfactory background and MVR check required after offer and prior to start date.

• Valid driver’s license is mandatory.

🏝️ Benefits

• Medical, Dental, Vision, Life, and Long-Term Disability insurance.

• Generous retirement savings plan.

• Flexible work schedules, including hybrid/remote options.

• Paid time off, including vacation, sick leave, holidays, and management leave.

• Dress flexibility.