Innovations Care Manager

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

📋 Description

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

• Perform thorough Health Risk Assessments that encompass behavioral, physical, developmental, social, and resource needs.

• Create and revise person-centered care plans in collaboration with members and interdisciplinary care teams.

• Connect members with suitable services and support across medical, behavioral health, I/DD, TBI, pharmacy, LTSS, and social-resource networks.

• Conduct screenings such as PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and others within the defined scope.

• Offer education, self-management strategies, referrals, and therapeutic support connections.

• Review and document medication information in Vaya’s Care Management system.

• Engage in interdisciplinary care team meetings, multidisciplinary huddles, case staffings, and high-risk team meetings.

• Provide crisis intervention, care coordination, transitional care management, and diversion support.

• Manage transitions between different levels of care and assist in preventing institutional placements or rehospitalizations.

• Monitor service delivery, perform announced and unannounced visits, and identify provider non-compliance.

• Ensure member health and safety, report critical incidents, and escalate concerns as necessary.

• Verify Medicaid eligibility and coordinate any related changes or deductibles.

• Generate and maintain precise care management documentation and Service Authorization Requests.

• Collaborate with providers, Vaya departments, community stakeholders, members, families, caregivers, and natural support systems.

• Participate in mandatory training and complete other assigned duties.

⛳️ Requirements

• Bachelor’s degree in health, psychology, sociology, social work, nursing, or another relevant human services discipline.

• Minimum of two years of experience working directly with individuals with I/DD or TBI.

• At least two years of previous experience in Long-Term Services and Supports and/or Home Community-Based Services coordination, care delivery monitoring, and care management.

• Must qualify as a North Carolina Qualified Professional as defined under 10A NCAC 27G .0104 for the population served.

• If the Bachelor’s degree is in a field other than Human Services, a total of four years of full-time accumulated experience with the population served is required.

• If the Bachelor’s degree is in Nursing and the incumbent is an RN, four years of full-time accumulated experience with the population served is necessary.

• If holding a Master’s degree in Human Services, a minimum of two years of full-time accumulated experience with the population served is required.

• If the Bachelor’s degree is in Nursing and the individual is an RN, they must be licensed by the North Carolina Board of Nursing to practice in North Carolina.

• Proficiency in Microsoft Office applications, Vaya systems, care management platforms, data analysis, and secondary research.

• Familiarity with the current version of the Diagnostic and Statistical Manual of Mental Disorders.

• Knowledge of the service arrays for MH/SU/IDD/TBI.

• Ability to articulate ideas clearly and communicate effectively.

• Capability to drive and remain seated for extended periods, including in rural locations.

• Must complete and maintain all required Vaya trainings and proficiencies.

• Residency in North Carolina or within 40 miles of the North Carolina border is required.

• Must reside in or near Polk, Rutherford, or Cleveland County to facilitate effective in-person contacts.

• Willingness to travel is essential.

🏝️ Benefits

• Eligible for overtime compensation.

• Non-exempt position.

• Flexible mobile/remote work arrangement.

• Equal opportunity employer.