Care Manager – LP

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

📋 Description

• Deliver proactive interventions and coordinate care for eligible members and recipients of Vaya Health.

• Evaluate members’ behavioral, developmental, medical, social, pharmacy, long-term services and supports (LTSS), and unmet health-related resource requirements.

• Recognize and address inappropriate levels of care and care gaps via assessment, multidisciplinary care planning, and service coordination.

• Perform Health Risk Assessments and administer screenings such as PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, along with other needs-based evaluations.

• Review and document current medications while maintaining integrated medication lists within Vaya’s care management platform.

• Create, update, and oversee person-centered care plans and crisis plans.

• Connect members with both formal and informal services and supports across various health domains.

• Offer education, self-management strategies, crisis intervention, clinical consultation, and suggestions for suitable care.

• Assess provider clinical evaluations for accuracy and completeness; collaborate with providers on complex clinical requirements.

• Lead interdisciplinary care teams, high-risk teams, complex case staffing, and care planning meetings.

• Assist with transitional care management, discharge follow-up, and prevention of institutional placements.

• Work in partnership with RNs, pharmacists, physicians, providers, families, caregivers, DSS, DJJ, CCNC, schools, and community stakeholders.

• Oversee service delivery, member health and safety, critical incidents, quality, eligibility, and care management outcomes.

• Ensure timely, accurate, and compliant documentation in the administrative health record.

• Engage in trainings, committees, workgroups, multidisciplinary huddles, and various departmental initiatives.

• Carry out other assigned responsibilities.

⛳️ Requirements

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

• For non-nursing master’s degree holders: a minimum of two years of experience working directly with individuals experiencing behavioral health conditions.

• For non-nursing master’s degree holders addressing LTSS needs: at least two years of previous experience in Long-Term Services and Supports and/or Home and Community Based Services coordination, care delivery monitoring, and care management.

• For nursing master’s degree holders: four years of full-time accumulated experience in mental health with the relevant population served.

• Must fulfill the criteria of being a North Carolina Qualified Professional with the population served as per 10A NCAC 27G .0104.

• A valid license is mandatory; acceptable licenses include RN, LCSW, LCSWA, LCMHC, LCMHCA, LCMHCS, LPA, HSP-PA, LCAS, LCASA, LMFT, or LMFTA.

• Preferred experience working directly with individuals with Intellectual/Developmental Disabilities (I/DD) or Traumatic Brain Injury (TBI).

• Proficiency in utilizing Vaya’s Care Management software platform and administrative health record.

• Adherence to HIPAA and Authorization for Release of Information practices.

• Competency in Microsoft Office applications, including Word, Excel, PowerPoint, Outlook, and Teams.

• Familiarity with the current version of the DSM relevant to the candidate’s scope.

• Extensive knowledge of the Mental Health/Substance Use/Intellectual Disabilities/Traumatic Brain Injury service array offered through Vaya’s provider network.

• Capacity to complete and retain all required Vaya trainings and proficiencies.

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

• Proficient in performing clinical assessments and determining member needs.

• Strong skills in problem-solving, negotiation, arbitration, conflict resolution, organization, and communication.

• Must be a resident of North Carolina or within 40 miles of the North Carolina border.

• Capability to travel and conduct in-person contacts with members and care teams.

🏝️ Benefits

• Exempt position; not eligible for overtime compensation.

• Mobile role with work performed in various locations.

• Vaya Health is an equal opportunity employer.