Care Manager – LP

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

📋 Description

• Deliver proactive intervention and care coordination for eligible members and recipients of Vaya Health.

• Perform thorough bio-psycho-social Health Risk Assessments that encompass social determinants of health, behavioral and physical health, daily living activities, and access to resources.

• Create, revise, and oversee person-centered care plans, crisis plans, and treatment objectives.

• Connect members to both formal and informal services and support systems across medical, behavioral health, I/DD, TBI, pharmacy, LTSS, and unmet health-related resource requirements.

• Implement PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and various needs-based screenings.

• Review and document medications, maintaining comprehensive medication lists across multiple sources within Vaya’s care management platform.

• Engage in and lead interdisciplinary care team meetings and complex case staffing sessions.

• Offer clinical consultation and technical assistance to providers; evaluate clinical assessments for accuracy and completeness.

• Conduct clinical assessments in cases where the absence of a clinical home or network provider poses significant risk to members.

• Provide crisis intervention, coordination, and care management in community environments.

• Assist with transitional care management and coordinate diversion initiatives for members at risk of institutionalization.

• Collaborate with members, legally responsible individuals, caregivers, providers, Vaya staff, DSS, DJJ, CCNC, educational institutions, and community stakeholders.

• Supervise service delivery, member health and safety, critical incidents, quality of care, and compliance with standards.

• Verify ongoing Medicaid eligibility and address members’ relocations outside Vaya’s service area.

• Generate and maintain accurate, timely records in the administrative health database.

• Ensure compliance with HIPAA, ROI practices, Vaya policies, NCDHHS standards, and contractual obligations.

• Participate in training sessions, committees, workgroups, huddles, and additional departmental projects.

• Travel to members’ communities and other locations for work-related activities.

⛳️ Requirements

• Master’s degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services discipline.

• North Carolina Qualified Professional credentialing with the population served under 10A NCAC 27G .0104.

• Valid licensure required: RN, LCSW, LCSWA, LCMHC, LCMHCA, LCMHCS, LPA, HSP-PA, LCAS, LCASA, LMFT, or LMFTA.

• For those with a non-nursing master’s degree: two years of direct experience with individuals experiencing behavioral health issues.

• For non-nursing master’s degree holders addressing LTSS needs: two years of coordination experience in LTSS and/or HCBS, care delivery monitoring, or care management; may overlap with behavioral health, I/DD, or TBI experience.

• For master’s degree holders in nursing: four years of full-time combined mental health experience with the population served; experience may be either prior to or following RN licensure.

• Capability to complete and uphold all required Vaya trainings and proficiencies.

• Proficiency in performing clinical assessments utilizing advanced clinical training and licensure.

• Comprehensive understanding of the current Diagnostic and Statistical Manual of Mental Disorders within the applicable scope.

• Significant knowledge of the MH/SU/IDD/TBI service spectrum.

• Intermediate to advanced skills in Microsoft Office applications and Vaya systems, including the care management platform, data analysis, and secondary research.

• Familiarity with NC Medicaid, NC Medicaid Transformation, Tailored Plans, state-funded services, and accreditation standards is preferred.

• Ability to drive and remain seated for extended periods, including in rural regions.

• Must reside in North Carolina or within 40 miles of the state border.

• Residence in or near the served counties is necessary for effective in-person member interactions.

• Strong communication skills for clear and effective interaction.

• Excellent problem-solving, negotiation, arbitration, conflict-resolution, organizational, and interpersonal abilities.

🏝️ Benefits

• Exempt position; not eligible for overtime pay.

• Required Vaya/Care Management training sessions and sustained training proficiencies.

• Equal opportunity employer.