health care manager

UPMC

<div><div><p>UPMC Community Care Behavioral Health is hiring a full-time Precert Care Manager. This role will work Monday - Friday 3:30 pm - midnight with rotating weekends and holidays. Occasional overnight coverage may be needed at times. This role works fully remote and must reside within 2 hours of a CCBH office location. Candidate should reside within Pennsylvania or the tri-state area.
</p><p>A Precert Care Manager for the 24 hour precert team must be able and willing to work daylight, evening, and night shift positions that also rotate weekend and holiday coverage. A Precert Care Manager is responsible for documenting and reviewing clinical information and making authorization determinations for adult and child/adolescent members being referred to acute and non-ambulatory mental health and substance use disorder levels of care for all Community Care contracts. The Care Manager will also be responsible for crisis management and referring members to appropriate services based on triage assessment. The Care Manager executes these responsibilities consistent with the applicable Community Care Policies and Procedures. A care manager represents the organization to providers, member groups and families, and participates in the overall administration of clinical operations as warranted. A care manager is expected to bring a level of clinical leadership to the care management department. In addition, a care manager may serve as the care management lead for other members of his/her team.<br>
<br>
<b>Responsibilities:</b><br>
</p><ul><li>Coordinates, reviews, and maintains daily logs for reporting purposes and for weekly preparation and analysis of trending reports to address member incidents, provider deficiencies, and quality of care concerns.</li><li>
Independently problem solves based on advanced-level knowledge of the service delivery system, clinical treatment, diversion resources, and the provider network for adult and child/adolescent members for behavioral health and SUD providers from the requested region, member services policies, members' rights and responsibilities, and the operating practices of the organization</li><li>
Responds to deadlines and has work completed on or before deadline 95% of the time.</li><li>
Identify need for and facilitate linkages for members and families between primary care and behavioral health providers and other social service or provider agencies to develop and coordinate service plans.</li><li>
Maintains an understanding of behavioral health benefits and remains current on covered benefits, limitations, exclusions, and policies and procedures, in regards to services. Is able to provide members, providers and other stakeholders with accurate information concerning benefits and coverage.</li><li>
Demonstrates excellent clinical, written and oral communication skills.</li><li>
Utilizes supervision with team coordinator and clinical manager regularly.</li><li>
Assumes responsibility for completion of acute and non-ambulatory precerts and application of appropriate medical necessity guidelines. Precerts include adult and child/adolescent members from all Community Care being admitted to mental health and substance use disorder services, as well as afterhours/weekend completion of precerts for UPMC Health Plan Commercial and SNP lines of business.</li><li>
Assist with moving members to in network facilities or coordinating with appropriate Community Care contracts regarding approval for out of network service utilization.</li><li>
Consults with appropriate physician advisors as needed for case collaboration and care planning.</li><li>
Develops specific clinical interventions and coordinates with the assigned Community Care contract and care management team for members who do not maintain regular contact with their behavioral health provider as recommended contributing to frequent crises, recidivism, and interfering with maximum benefit from available care.</li><li>
Participates in professional development activities to further clinical skills and knowledge. Works as part of a team providing clinical expertise and knowledge to member services and other care management staff.</li><li>
Demonstrates advanced level of computer operation with electronic medical record systems and Microsoft Outlook, Word, and Excel Programs, as well as advanced typing proficiency.</li><li>
Receives and responds appropriately to complex calls, including Afterhours/Weekend Employee Assistance Program calls, triage calls, and provider or member complaints. Ensures accurate, thorough, and correct documentation of these calls.</li></ul></div><div><ul><li>
A current and unrestricted Pennsylvania Licensure in health or human services field (LSW, LCSW, LPC, LMFT) and master's degree OR licensed RN (BSN preferred)
</li><li>Minimum of three years of relevant clinical experience.
</li><li>Experience with both adult and child/adolescent populations and mental health and substance use disorder services strongly preferred.
</li><li>Experience in managed care strongly preferred.
</li><li>General knowledge of best practices in behavioral health, emphasizing work with special needs or priority populations and in public sector systems.
</li><li>Certification in substance use disorders helpful.
</li><li>PCPC 3rd Edition, ASAM, and Confidentiality Training preferred.
</li><li>Supervisory or other leadership experience in behavioral health also preferred<br>
<br>
<b>Licensure, Certifications, and Clearances:</b><br>
</li><li><p>Act 73 FBI
</p><p>Clearance
</p></li><p></p><li>Act 34 Criminal Clearance w Renewal
</li><li>Act 33 Child Clearance w Renewal
</li><li><p>Behavior Specialist OR Clinical Social Work OR Licensed Mar &amp; Fam Therapist OR Licensed Social Worker OR Professional Counselor OR Psychologist OR Registered Nurse
</p></li><p></p><li>Act 33 with renewal</li><li>
Act 34 with renewal</li><li>
Act 73 FBI Clearance with renewal</li><li>Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state.</li></ul><br>
<b>
UPMC is an Equal Opportunity Employer/Disability/Veteran</b></div></div>

Precert Care Manager (Evening Shift)

Humana

<div><h1 class="jobSectionHeader"><b>Become a part of our caring community and help us put health first</b><br>
</h1>
The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.<p></p><p>
The Care Manager, Telephonic Behavioral Health 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.</p><h1 class="jobSectionHeader"><b><br>
Use your skills to make an impact</b><br>
<b>
</b></h1><p><b>Scheduled Hours</b></p><p></p><ul><li>
The working hours for this position are Monday-Friday from 9:30 am &ndash; 6:00 pm EST.</li><li>
The first 2 weeks of training will be from 8:30 AM to 5:00 PM EST.</li><li>
No time off is permitted during the first month of training. The first 90 days following training are critical in building your foundation; therefore, planned or unplanned time will not be permitted.</li></ul><p><b><br>
Key Responsibilities</b></p><p></p><ul><li>
Serve as a Licensed, Master&rsquo;s-level Social Worker within the Special Needs Plan (SNP) program, functioning as a Support Social Services associate and interdisciplinary care team member.</li><li>
Conduct telephonic outreach to members with social determinants of health (SDOH) needs to assess, support, and coordinate care using plan benefits and community resources.</li><li>
Utilize structured assessments and critical thinking to determine appropriate interventions, including care coordination, health education, resource connection, and advocacy.</li><li>
Collaborate with interdisciplinary team members (e.g., nurse care managers, dietitians, behavioral health, pharmacists), providers, and community partners to address member needs.</li><li>
Handle both outbound and inbound member interactions in a fast-paced, telephonic, work-from-home environment; perform follow-up as needed to ensure all needs are addressed.</li><li>
Assess members for additional support needs and initiate referrals to appropriate disciplines based on individualized circumstances.</li><li>
Develop, update, and maintain member care plans as needed to support ongoing care coordination.</li><li>
Document all interactions and care activities accurately in the member record to ensure CMS compliance and reflect engagement with members and care teams.</li></ul><p></p><p><b>
Required Qualifications</b></p><p></p><ul><li>
Master&rsquo;s degree in social work from an accredited university</li><li>
Current, unincumbered, social work license (LMSW, LCSW, or LICSW).</li><li>
Must have passed ASWB Exam (Master, Advance Generalist, or Clinical level).</li><li>
Minimum 3 years of experience working as a social worker in a medical healthcare setting.</li><li>
Proficient in Microsoft applications including Word, Outlook, Excel</li><li>
Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.</li><li>
Must be willing to obtain/maintain social work licensure in multiple states, based on business need.</li></ul><p></p><p><b>
Preferred Qualifications</b></p><p></p><ul><li>
Experience working with geriatric, vulnerable, and/or low-income populations</li><li>
Licensure in AL, AR, IN, LA, MO, MS, NC, OK, SC, or WA</li><li>
Bilingual English/Spanish or English/Creole</li><li>
Experience working with Medicare and Medicaid</li></ul><p></p><p><b>
Work-At-Home Requirements:</b></p><ul><li><p><br>
You must have a separate room with a locked door that can be used as a home office to ensure continuous privacy while you work.</p></li><li><p>
High-speed DSL or cable modem for a home office (minimum: 25 Mbps download / 10 Mbps upload).</p></li><li><p>
Satellite and wireless internet services are <b>NOT </b>permitted.</p></li><li><p>
Dedicated workspace to maintain confidentiality of PHI/HIPAA information.</p></li><li><p>
Associates or contractors working from California will receive internet expense reimbursement.</p></li></ul><p></p>
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.<p></p><p><b>
Scheduled Weekly Hours</b></p><p></p>
40<p></p><p><b>
Pay Range</b></p>
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.<br>
<p></p>
$59,300 - $80,900 per year<br>
<p></p>
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.<p></p><p><b>
Description of Benefits</b></p>
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<p></p><h1 class="jobSectionHeader"><b><br>
About us</b><br>
</h1>
Humana Inc. (NYSE: HUM) is committed to putting health first &ndash; for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health &ndash; delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.<p></p><p><br>
<br>
<b>Equal Opportunity Employer</b></p><p></p><p>
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</p></div>

Care Manager, Behavioral Health

Total Life

<div>
 <strong>
  <strong>
   Description
   <br/>
   <br/>
  </strong>
 </strong>
 Position Description: Telehealth RN
 <br/>
 <br/>
 Location: Remote (Telehealth) - Must hold an active Florida RN license
 <br/>
 <br/>
 Schedule: Daytime hours, Monday-Friday (normal business hours)
 <br/>
 <br/>
 Compensation: Negotiable, based on experience
 <br/>
 <br/>
 <strong>
  About Us:
  <br/>
  <br/>
 </strong>
 At Total Life, we're on a mission to support healthier aging and address mental health challenges by making high-quality, affordable emotional support services accessible to all older adults. As a behavioral health organization dedicated to older adult care, we use evidence-based practices to help clients live emotionally healthy, connected, and fulfilling lives.
 <br/>
 <br/>
 <strong>
  <strong>
   Position Overview
   <br/>
   <br/>
  </strong>
 </strong>
 Job Title: Registered Nurse (Florida Licensed) - Geriatric Behavioral Health Care Manager (Telehealth)
 <br/>
 <br/>
 <strong>
  <strong>
   Position Overview
   <br/>
   <br/>
  </strong>
 </strong>
 We are seeking a Florida-licensed Registered Nurse to serve as a Care Manager for our geriatric behavioral health program. This telehealth role focuses on ongoing mental health support, dementia care management, and caregiver guidance for older adults. The RN will provide structured monthly patient engagement and coordinate care within a multidisciplinary team that includes psychiatry, nurse practitioners/physician assistants, psychology, and nutrition services.
 <br/>
 <br/>
 This position offers a predictable daytime schedule with no evenings, weekends, or call requirements.
 <br/>
 <br/>
 <strong>
  Patient Population
  <br/>
  <br/>
 </strong>
 Adults age 65 and older
 <br/>
 <br/>
 <ul>
  <li>
   Patients in assisted living, long-term care, and community settings
  </li>
  <li>
   Common conditions include dementia, mild cognitive impairment, depression, anxiety, behavioral symptoms of dementia, and complex medical and psychosocial needs
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   Key Responsibilities
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Provide a minimum of 60 minutes of patient and/or caregiver touchpoints per month through scheduled telehealth or phone-based care management
  </li>
  <li>
   Monitor mental health symptoms, cognitive and behavioral changes, medication adherence, and overall functioning
  </li>
  <li>
   Support dementia care planning, behavioral strategies, and safety considerations
  </li>
  <li>
   Provide education and emotional support to caregivers and family members
  </li>
  <li>
   Identify clinical concerns and escalate to psychiatry or medical providers as appropriate
  </li>
  <li>
   Reinforce treatment plans developed by psychiatry, PA/NP, psychology, and nutrition
  </li>
  <li>
   Coordinate services and ensure continuity of care across the multidisciplinary team
  </li>
  <li>
   Maintain timely and accurate documentation within the EMR
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   Qualifications
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Active, unrestricted Florida RN license (required)
  </li>
  <li>
   Experience in geriatric care, behavioral health, dementia care, or care management strongly preferred
  </li>
  <li>
   Strong understanding of mental health conditions and behavioral symptoms in older adults
  </li>
  <li>
   Experience supporting caregivers and families
  </li>
  <li>
   Comfortable delivering care via telehealth and phone-based outreach
  </li>
  <li>
   Excellent communication, organization, and care coordination skills
  </li>
  <li>
   Ability to work independently within a structured, team-based care model
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   What We Offer
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Fully remote work environment
  </li>
  <li>
   Consistent daytime schedule and strong work-life balance
  </li>
  <li>
   Supportive multidisciplinary clinical team
  </li>
  <li>
   Structured patient engagement model with clear expectations
  </li>
  <li>
   Flexible compensation structure
  </li>
  <li>
   Opportunity to make a meaningful impact in the lives of older adults and their caregivers
  </li>
  <li>
   Minimal administrative burden with strong clinical support
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   About The Role
   <br/>
   <br/>
  </strong>
 </strong>
 This is an ideal opportunity for an RN who is passionate about relationship-based care, proactive patient engagement, and supporting medically and emotionally complex geriatric patients within a collaborative behavioral health model.
 <br/>
 <br/>
 <strong>
  <strong>
   What We Offer
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Fully remote work environment
  </li>
  <li>
   Consistent daytime schedule and strong work-life balance
  </li>
  <li>
   Supportive administrative, nursing, and psychiatric leadership team
  </li>
  <li>
   Flexible compensation structure
  </li>
  <li>
   Opportunity to make a meaningful impact in an underserved geriatric population
  </li>
  <li>
   Minimal administrative burden with strong clinical support
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  What Will Set You Apart:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Experience working with older adults or in geriatric mental health
  </li>
  <li>
   Strong interpersonal and communication skills with a compassionate, patient-centered approach
  </li>
  <li>
   Bilingual in English/Spanish is a plus
  </li>
  <li>
   Established relationships within your local community
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   Benefits &amp; Compensation
   <br/>
   <br/>
  </strong>
 </strong>
 <ul>
  <li>
   Extremely competitive salary
  </li>
  <li>
   Full-time position with comfortable visit lengths
  </li>
  <li>
   Supportive clinical and administrative team
  </li>
  <li>
   Opportunities for professional growth, leadership, and meaningful impact within a mission-driven organization
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Schedule
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Monday - Friday FT position
  </li>
  <li>
   Completing care plans focused on geriatric mental health population
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  <strong>
   How To Apply
   <br/>
   <br/>
  </strong>
 </strong>
 Please attach your resume and a brief note about your interest in supporting healthier aging in your community. We look forward to meeting passionate clinicians ready to make a difference.
 <br/>
 <br/>
 <strong>
  Our Commitment:
  <br/>
  <br/>
 </strong>
 Total Life is proud to be an equal opportunity employer. We value diversity, inclusion, and respect, ensuring a workplace free from discrimination and harassment.
</div>


RN Telehealth

Epiphany Family Services, LLC

<div><div><b>TCM Care Manager</b></div><div><b>
Department:</b> Tailored Care Management</div><div><b>
Location:</b> Hybrid (In-Office, Field, and Remote)</div><div><b>
Schedule:</b> Monday &ndash; Friday | 8:30 AM &ndash; 5:00 PM</div><div></div><div><b><br>
Position Summary</b></div><div></div><div><b><br>
Epiphany Family Services is seeking a compassionate and detail-oriented TCM Care Manager</b> to serve as the primary point of coordination for individuals enrolled in our Tailored Care Management (TCM) program.</div><div></div><div><br>
This role ensures the delivery of <b>person-centered, comprehensive, and high-quality care</b> by assessing needs, developing individualized service plans, coordinating services, and advocating for clients. The Care Manager collaborates with individuals, families, healthcare providers, and community partners to improve overall health outcomes and quality of life.</div><div></div><div><br>
Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions. Additional duties may be assigned as needed.</div><div></div><div><b><br>
Key Responsibilities</b></div><div><b>
Care Management &amp; Coordination</b></div><br>
<div></div><ul><li>
Conduct comprehensive assessments of physical, behavioral health, and social needs</li><li>
Develop, implement, and monitor individualized care plans based on client goals</li><li>
Coordinate services across medical, behavioral health, housing, and social service systems</li><li>
Provide ongoing follow-up, care coordination, and health promotion</li></ul><div><b>
Referrals &amp; Resource Linkage</b></div><br>
<div></div><ul><li>
Connect individuals to appropriate community resources</li><li>
Address Social Determinants of Health (SDOH), including housing, education, access to care, and community support</li><li>
Empower individuals to actively manage their health and wellness</li></ul><div><b>
Transitions of Care</b></div><ul><li><b>
Coordinate follow-up within 24 hours of hospital or emergency department discharge</b></li></ul><br>
<div></div><ul><li>
Support individuals through life transitions (e.g., housing changes, incarceration release)</li></ul><div><b>
Crisis Response</b></div><br>
<div></div><ul><li>
Identify and respond to crisis situations in accordance with agency protocols</li><li>
Participate in on-call rotation and 24/7 crisis response as required</li><li>
Participate in post-crisis debriefings and prevention planning</li></ul><div><b>
Collaboration &amp; Advocacy</b></div><br>
<div></div><ul><li>
Build and maintain relationships with interdisciplinary care teams and community partners</li><li>
Advocate for equitable access to services and resources</li><li>
Educate clients and families on available services and self-management strategies</li></ul><div><b>
Documentation &amp; Compliance</b></div><br>
<div></div><ul><li>
Maintain accurate, timely, and compliant documentation in accordance with state, federal, and program guidelines</li><li>
Monitor client progress and adjust care plans as needed</li></ul><div><b>
Quality Improvement &amp; Additional Duties</b></div><br>
<div></div><ul><li>
Participate in team meetings, trainings, and Quality Improvement (QI) initiatives</li><li>
Monitor utilization, outcomes, and compliance metrics</li><li>
Perform additional duties as assigned</li></ul><div></div><div><b><br>
Qualifications</b></div><div><b>
Education &amp; Experience</b></div><br>
<div></div><ul><li>
Bachelor&rsquo;s degree in Social Work, Nursing, Human Services, or related field required; Master&rsquo;s preferred</li><li>
Minimum of 2 years of experience in care management, case management, or care coordination</li><li>
Experience working with individuals with behavioral health conditions, chronic health needs, or social barriers.</li></ul><div></div><div><b><br>
Qualified Professional (QP) Requirements &ndash; North Carolina</b></div><div>
Candidates must meet Qualified Professional (QP) criteria in accordance with 10A NCAC 27G. To qualify, candidates must meet <b>one</b> of the following:</div><br>
<div></div><ul><li>
Be a fully certified professional through the North Carolina Addictions Specialist Professional Practice Board (NCASPPB) with 4 years of full-time experience working with the MH/DD/SUD population</li><li><i>
Note: CADC-R and CADC-I are not considered full certification</i></li></ul><div><b>
OR</b></div><br>
<div></div><ul><li>
Meet degree and experience requirements as follows:</li></ul><div><b>
For CADC Credential Holders:</b></div><br>
<div></div><ul><li>
If, no college degree:</li><li>
Minimum 4 years of full-time experience with MH/DD/SUD population</li><li>
If college graduate: must meet one of the following:</li><li>
Master&rsquo;s degree in a human services field + 1 year of supervised MH/DD/SUD experience</li><li>
Bachelor&rsquo;s degree in a human services field + 2 years of supervised MH/DD/SUD experience</li><li>
Bachelor&rsquo;s degree in a non-human services field + 4 years of supervised MH/DD/SUD experience</li></ul><div><b>
OR</b></div><br>
<div></div><ul><li>
Be a Substance Use Disorder Professional with equivalent supervised experience:</li><li><b>
1 year</b> (Master&rsquo;s level)</li><li><b>
2 years</b> (Bachelor&rsquo;s in human services)</li><li><b>
4 years</b> (Bachelor&rsquo;s in non-human services)</li></ul><div><b>
</b></div><div><b>
Skills &amp; Competencies</b></div><br>
<div></div><ul><li>
Strong understanding of care management principles and community resources</li><li>
Knowledge of <b>ICD-10 coding</b> and behavior management techniques</li><li>
Excellent communication, organizational, and problem-solving skills</li><li>
Ability to manage a caseload and prioritize effectively</li><li>
Proficiency in EHR systems and Microsoft Office</li></ul><div><b>
</b></div><div><b>
Licensure/Certification (Preferred)</b></div><br>
<div></div><ul><li>
Licensed Social Worker, Registered Nurse, or other applicable credential</li><li>
Valid driver&rsquo;s license and reliable transportation for community-based work</li></ul><div><b>
</b></div><div><b>
Work Environment</b></div><br>
<div></div><ul><li>
Hybrid work model (in-office, remote, and field-based services)</li><li>
Travel within assigned service areas required</li><li>
Flexible hours may be needed to meet client needs</li><li>
Care Manager JD</li></ul><div><b>
</b></div><div><b>
Benefits</b></div><div></div><div><b><br>
Epiphany Family Services offers a comprehensive and competitive benefits package:</b></div><br>
<div></div><ul><li>
Medical, Dental, and Vision Insurance</li><li>
Short-Term Disability (STD) &amp; Long-Term Disability (LTD)</li><li>
Group Life Insurance</li><li><b>
80 Hours of PTO</b> (Vacation, Sick, and Personal Time)</li><li>
Paid Holidays</li><li>
Employee Discount Program (Tickets at Work)</li></ul><div><b>
</b></div><div><b>
About Epiphany Family Services</b></div><div></div><div><b><br>
Epiphany Family Services is committed to providing an integrated system of care to individuals from diverse backgrounds. We empower those experiencing mental health and substance use challenges with the tools needed to achieve and sustain recovery.</b></div><div></div><div><b><br>
Join Our Team</b></div><div></div><ul><li><b><br>
If you are passionate about making a meaningful impact and providing high-quality, person-centered care, we encourage you to apply and grow with us.</b></li></ul><p>
E04JI802okl940908wj</p></div>

TCM Care Manager - Gastonia

<div><div><b>TCM Care Manager</b></div><div><b>
Department:</b> Tailored Care Management</div><div><b>
Location:</b> Hybrid (In-Office, Field, and Remote)</div><div><b>
Schedule:</b> Monday &ndash; Friday | 8:30 AM &ndash; 5:00 PM</div><div></div><div><b><br>
Position Summary</b></div><div></div><div><b><br>
Epiphany Family Services is seeking a compassionate and detail-oriented TCM Care Manager</b> to serve as the primary point of coordination for individuals enrolled in our Tailored Care Management (TCM) program.</div><div></div><div><br>
This role ensures the delivery of <b>person-centered, comprehensive, and high-quality care</b> by assessing needs, developing individualized service plans, coordinating services, and advocating for clients. The Care Manager collaborates with individuals, families, healthcare providers, and community partners to improve overall health outcomes and quality of life.</div><div></div><div><br>
Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions. Additional duties may be assigned as needed.</div><div></div><div><b><br>
Key Responsibilities</b></div><div><b>
Care Management &amp; Coordination</b></div><ul><li>
Conduct comprehensive assessments of physical, behavioral health, and social needs</li><li>
Develop, implement, and monitor individualized care plans based on client goals</li><li>
Coordinate services across medical, behavioral health, housing, and social service systems</li><li>
Provide ongoing follow-up, care coordination, and health promotion</li></ul><div></div><div><b><br>
Referrals &amp; Resource Linkage</b></div><ul><li>
Connect individuals to appropriate community resources</li><li>
Address Social Determinants of Health (SDOH), including housing, education, access to care, and community support</li><li>
Empower individuals to actively manage their health and wellness</li></ul><div></div><div><b><br>
Transitions of Care</b></div><ul><li><b>
Coordinate follow-up within 24 hours of hospital or emergency department discharge</b></li><li>
Support individuals through life transitions (e.g., housing changes, incarceration release)</li></ul><div></div><div><b><br>
Crisis Response</b></div><ul><li>
Identify and respond to crisis situations in accordance with agency protocols</li><li>
Participate in on-call rotation and 24/7 crisis response as required</li><li>
Participate in post-crisis debriefings and prevention planning</li></ul><div></div><div><b><br>
Collaboration &amp; Advocacy</b></div><ul><li>
Build and maintain relationships with interdisciplinary care teams and community partners</li><li>
Advocate for equitable access to services and resources</li><li>
Educate clients and families on available services and self-management strategies</li></ul><div></div><div><b><br>
Documentation &amp; Compliance</b></div><ul><li>
Maintain accurate, timely, and compliant documentation in accordance with state, federal, and program guidelines</li><li>
Monitor client progress and adjust care plans as needed</li></ul><div></div><div><b><br>
Quality Improvement &amp; Additional Duties</b></div><ul><li>
Participate in team meetings, trainings, and Quality Improvement (QI) initiatives</li><li>
Monitor utilization, outcomes, and compliance metrics</li><li>
Perform additional duties as assigned</li></ul><div></div><div><b><br>
Qualifications</b></div><div><b>
Education &amp; Experience</b></div><ul><li>
Bachelor&rsquo;s degree in Social Work, Nursing, Human Services, or related field required; Master&rsquo;s preferred</li><li>
Minimum of 2 years of experience in care management, case management, or care coordination</li><li>
Experience working with individuals with behavioral health conditions, chronic health needs, or social barriers.</li></ul><div></div><div><b><br>
Qualified Professional (QP) Requirements &ndash; North Carolina</b></div><div><b>
Candidates must meet Qualified Professional (QP)</b> criteria in accordance with <b>10A NCAC 27G</b>. To qualify, candidates must meet <b>one</b> of the following:</div><ul><li>
Be a fully certified professional through the North Carolina Addictions Specialist Professional Practice Board (NCASPPB) with 4 years of full-time experience working with the MH/DD/SUD population</li><li><i>
Note: CADC-R and CADC-I are not considered full certification</i></li></ul><div><b>
OR</b></div><ul><li>
Meet degree and experience requirements as follows:</li></ul><div></div><div><b><br>
For CADC Credential Holders:</b></div><ul><li>
If, no college degree:</li><li>
Minimum 4 years of full-time experience with MH/DD/SUD population</li><li>
If college graduate: must meet one of the following:</li><li>
Master&rsquo;s degree in a human services field + 1 year of supervised MH/DD/SUD experience</li><li>
Bachelor&rsquo;s degree in a human services field + 2 years of supervised MH/DD/SUD experience</li><li>
Bachelor&rsquo;s degree in a non-human services field + 4 years of supervised MH/DD/SUD experience</li></ul><div><b>
OR</b></div><ul><li>
Be a Substance Use Disorder Professional with equivalent supervised experience:</li><li><b>
1 year</b> (Master&rsquo;s level)</li><li><b>
2 years</b> (Bachelor&rsquo;s in human services)</li><li><b>
4 years</b> (Bachelor&rsquo;s in non-human services)</li></ul><div><b>
</b></div><div><b>
Skills &amp; Competencies</b></div><ul><li>
Strong understanding of care management principles and community resources</li><li>
Knowledge of <b>ICD-10 coding</b> and behavior management techniques</li><li>
Excellent communication, organizational, and problem-solving skills</li><li>
Ability to manage a caseload and prioritize effectively</li><li>
Proficiency in EHR systems and Microsoft Office</li></ul><div><b>
</b></div><div><b>
Licensure/Certification (Preferred)</b></div><ul><li>
Licensed Social Worker, Registered Nurse, or other applicable credential</li><li>
Valid driver&rsquo;s license and reliable transportation for community-based work</li></ul><div><b>
</b></div><div><b>
Work Environment</b></div><ul><li>
Hybrid work model (in-office, remote, and field-based services)</li><li>
Travel within assigned service areas required</li><li>
Flexible hours may be needed to meet client needs</li><li>
Care Manager JD</li></ul><div><b>
</b></div><div><b>
Benefits</b></div><div></div><div><b><br>
Epiphany Family Services offers a comprehensive and competitive benefits package:</b></div><ul><li>
Medical, Dental, and Vision Insurance</li><li>
Short-Term Disability (STD) &amp; Long-Term Disability (LTD)</li><li>
Group Life Insurance</li><li><b>
80 Hours of PTO</b> (Vacation, Sick, and Personal Time)</li><li>
Paid Holidays</li><li>
Employee Discount Program (Tickets at Work)</li></ul><div><b>
</b></div><div><b>
About Epiphany Family Services</b></div><div></div><div><b><br>
Epiphany Family Services is committed to providing an integrated system of care to individuals from diverse backgrounds. We empower those experiencing mental health and substance use challenges with the tools needed to achieve and sustain recovery.</b></div><div></div><div><b><br>
Join Our Team</b></div><div></div><div><b><br>
If you are passionate about making a meaningful impact and providing high-quality, person-centered care, we encourage you to apply and grow with us.</b></div><p>
E04JI802okl940908qx</p></div>

TCM Care Manager - Charlotte

Vaya Health

<div><div><b>LOCATION:</b> Remote &ndash; must live in or near McDowell County, North Carolina. The person in this position is required to maintain residency in North Carolina or within 40 miles of the NC border. <i>This position requires travel</i>.</div><div></div><div><b><br>
GENERAL STATEMENT OF JOB</b></div><div>
The Care Manager Licensed Professional (&ldquo;Care Manager - LP&rdquo;) is responsible for providing proactive intervention and coordination of care to eligible Vaya Health members and recipients (&ldquo;members&rdquo;) to ensure that these individuals receive appropriate assessment and services. The Care Manager - LP works with the member and care team to identify and alleviate inappropriate levels of care or care gaps through assessment, multidisciplinary team care planning, linkage and/or coordination of services needed by the member across the MH, SU, intellectual/ developmental disability (&ldquo;I/DD&rdquo;), traumatic brain injury (&ldquo;TBI&rdquo;) physical health, pharmacy, long-term services and supports (&ldquo;LTSS&rdquo;) and unmet health-related resource needs networks. Care Manager - LP supports and may provide clinical transition planning assistance to state, and community hospitals and residential facilities and track individuals discharged from facility settings to ensure they follow up with aftercare services and receive needed assistance to prevent further hospitalization. This is a mobile position with work done in a variety of locations, including members&rsquo; home communities. The Care Manager - LP also works with other Vaya staff, members, relatives, caregivers/ natural supports, providers, and community stakeholders. <b>The Care Manager - LP also utilizes licensed clinical knowledge and skills to assess needs, inform care planning development, provide clinical consultation, and offer recommendations for appropriate care.</b></div><div></div><div><br>
As further described below, essential job functions of the Care Manager - LP includes, but may not be limited to:</div><ul><li>
Utilization of and proficiency with Vaya&rsquo;s Care Management software platform/ administrative health record (&ldquo;AHR&rdquo;)</li><li>
Outreach and engagement</li><li>
Compliance with HIPAA (Health Insurance Portability and Accountability) requirements, including Authorization for Release of Information (&ldquo;ROI&rdquo;) practices</li><li>
Performing Health Risk Assessments (HRA): a comprehensive bio-psycho-social assessment addressing social determinants of health, mental health history and needs, physical health history and needs, activities of daily living, access to resources, and other areas to ensure a whole person approach to care</li><li>
Adherence to Medication List and Continuity of Care processes</li><li>
Participation in interdisciplinary care team meetings, comprehensive care planning, and ongoing care management</li><li>
Transitional Care Management</li><li>
Divers</li><li>
ion from institutional placement</li></ul><div></div><div><br>
This position is required to meet NC (North Carolina) Residency requirements as defined by the NC Department of Health and Human Services (&ldquo;NCDHHS&rdquo; or &ldquo;Department&rdquo;). This position is required to live in or near the counties served to effectively deliver in-person contacts with members and their care teams.</div><div></div><div><b><br>
ESSENTIAL JOB FUNCTIONS</b></div><div><b>
Clinical Assessment, Care Planning, and Interdisciplinary Care Team:</b></div><div><ul><li>
Ensures identification, assessment, and appropriate person-centered care planning for members.</li><li>
Links members with appropriate and necessary formal/ informal services and supports across all health domains (i.e., medical, and behavioral health home)</li><li>
Meets with members to conduct the HRA and gather information on their overall health, including behavioral health, developmental, medical, and social needs.</li><li>
Administers the PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other screenings based on member&rsquo;s needs. The Care Manager - LP uses these screenings to provide specific education and self-management strategies as well as linkage to appropriate therapeutic supports.<ul><li>
The assessment process includes reviewing and transcribing member&rsquo;s current medication and entering information into Vaya&rsquo;s Care Management platform, which triggers the creation of a multisource medication list that is shared back with prescribers to promote integrated care.</li></ul></li><li>
Supports the care team in development of a person-centered care plan (&ldquo;Care Plan&rdquo;) to help define what is important to members for their health and prioritize goals that help them live the life they want in the community of their choice.<ul><li>
Ensure the Care Plan includes specific services to address mental health, substance use, medical and social needs as well as personal goals</li><li>
Ensure the Care Plan includes all elements required by NCDHHS</li><li>
Use information collected in the assessment process to learn about member's needs and assist in care planning</li><li>
Ensure members of the care team are involved in the assessment as indicated by the member/LRP and uses clinical skills to evaluate and incorporate other available clinical information into the assessment as necessary</li><li>
Work with members to identify barriers and help resolve dissatisfaction with services or community-based interventions</li></ul></li><li>
Uses clinical skills and expertise to review clinical assessments conducted by providers to ensure all areas of the member&rsquo;s needs are addressed. Care Manager - LP reviews for clinical accuracy and may provide consultation and technical support to providers as needed based on reviews.</li><li>
Interprets and analyzes clinical assessments to draw clinical conclusions to support care management activities.</li><li>
Engages with provider clinical staff to determine clinical appropriateness and course of action when assessments present a wide array of treatment options and members present with complex needs.</li><li>
Helps members refine and formulate treatment goals, identifying interventions, measurements, and barriers to the goals</li><li>
Ensures that member/legally responsible person (&ldquo;LRP&rdquo;) is/are informed of available services, referral processes (e.g., requirements for specific service), etc.</li><li>
Provides information to member/LRP regarding their choice of service providers, ensuring objectivity in the process</li><li>
Works in an integrated care team including, but not limited to, an RN and pharmacist along with the member to address needs and goals in the most effective way ensuring that member/LRP could decide who they want involved</li><li>
Supports and may facilitate care team meetings where member Care Plan is discussed and reviewed</li><li>
Solicits input from the care team and monitor progress</li><li>
Ensures that the assessment, Care Plan, and other relevant information is provided to the care team</li><li>
Reviews assessments conducted by providers and consult with clinical staff as needed to ensure all areas of the member&rsquo;s needs are addressed</li><li>
Provide clinical assessment in situations where the member&rsquo;s lack of clinical home or available network provider creates significant risk to member well-being (e.g., need for time sensitive placement/ discharge from inpatient setting)</li><li>
Updates Care Plans and Care Management assessment at a minimum of annually or when there is a significant life change for the member</li><li>
Supports and assists with education and referral to prevention and population health management programs.</li><li>
Works with the member/LRP and care team to ensure the development of a Care Management Crisis Plan for the member that is tailored to their needs and desires, which is separate and complementary to the behavioral health provider&rsquo;s crisis plan<ul><li>
Ensures the crisis plan includes problem definition, physical/cognitive limitations, health risks/concerns, medication alerts, baseline functioning, signs/symptoms of crisis (triggers), de-escalation techniques.</li><li>
Provides crisis intervention, coordination, and care management if needed while with members in the community.</li></ul></li><li>
Supports Transitional Care Management responsibilities for members transitioning between levels of care</li><li>
Coordinates Diversion efforts for members at risk of requiring care in an institutional setting</li><li>
Consults with care management licensed professionals, care management supervisors, and other colleagues as needed to support effective and appropriate member care.</li></ul></div><div></div><div><b><br>
Collaboration, Coordination, Documentation:</b></div><div><ul><li>
Utilizes advanced knowledge in their work which requires use of their advanced degree and licensure to be able to participate and initiate independent decisions with matters of significance and drive positive clinical outcomes for Vaya members.</li><li>
Executes independent discretion and engages in business decisions for the Vaya Care Management Department that support initiatives to promote Vaya&rsquo;s integrated, whole-person care model for members.</li><li>
Serves as a collaborative partner in identifying system barriers through work with community stakeholders.</li><li>
Manages and facilitates Child/Adult High-Risk Team meetings in collaboration with DSS, DJJ, CCNC, school systems, and other community stakeholders as appropriate.</li><li>
Works in partnership with other Vaya departments to identify and address gaps in services/ access to care within Vaya&rsquo;s catchment.</li><li>
Participates in cross-functional clinical and non-clinical meetings and other projects as needed/ requested to support the department and organization.</li><li>
Participates in routine multidisciplinary huddles including RN, Pharmacist, M.D. to present complex clinical case presentation and needs, providing support to other CMs (Care Manager) and receiving support and feedback regarding CM interventions for clients&rsquo; medical, behavioral health, intellectual /developmental disability, medication, and other needs.</li><li>
Participates in other high risk multidisciplinary complex case staffing as needed to include Vaya CMO/ Deputy CMO, Utilization Management, Provider Network, and Care Management leadership to address barriers, identify need for specialized services to meet client needs within or outside the current behavioral health system.</li><li>
Monitors provision of services to informally measure quality of care delivered by providers and identify potential non-compliance with standards.</li><li>
Ensures the health and safety of members receiving care management, recognize and report critical incidents, and escalate concerns about health and safety to care management leadership as needed.</li><li>
Supports problem-solving and goal-oriented partnership with member/LRP, providers, and other stakeholders.</li><li>
Promotes member satisfaction through ongoing communication and timely follow-up on any concerns/issues.</li><li>
Supports and assists members/families on services and resources by using educational opportunities to present information.</li><li>
Verifies member&rsquo;s continuing eligibility for Medicaid, and proactively responds to a member&rsquo;s planned movement outside Vaya&rsquo;s catchment area to ensure changes in their Medicaid county of eligibility are addressed prior to any loss of service.</li><li>
Proactively and timely creates and monitors documentation within the AHR to ensure completeness, accuracy and follow through on care management tasks.</li><li>
Maintains electronic AHR compliance and quality according to Vaya policy.</li><li>
Ensures all clinical and non-clinical documentation (e.g. goals, plans, progress notes, etc.) meet all applicable federal, state, and Vaya requirements, including requirements within Vaya&rsquo;s contracts with NCDHHS.</li><li>
Participates in all required Vaya/ Care Management trainings and maintains all required training proficiencies.</li><li>
Participates in Vaya committees, workgroups, and other efforts that require clinical knowledge, as requested, and identified.</li></ul></div><div></div><div><b><br>
Other duties as assigned.</b></div><div></div><div><b><br>
KNOWLEDGE, SKILLS, &amp; ABILITIES</b></div><ul><li>
Ability to express ideas clearly/concisely and communicate in a highly effective manner</li><li>
Ability to drive and sit for extended periods of time (including in rural areas)</li><li>
Exceptional interpersonal skills and ability to represent Vaya in a professional manner</li><li>
Ability to initiate and build relationships with people in an open, friendly, and accepting manner</li><li>
Strong attention to detail and superior organizational skills</li><li>
Ability to make prompt independent decisions based upon relevant facts.</li><li>
Well-developed capabilities in problem solving, negotiation, arbitration, and conflict resolution, including a high level of diplomacy and discretion to effectively negotiate and resolve issues with minimal assistance.</li><li>
A result and success-oriented mentality, conveying a sense of urgency and driving issues to closure</li><li>
Comfort with adapting and adjusting to multiple demands, shifting priorities, ambiguity, and rapid change</li><li>
Thorough knowledge of standard office practices, procedures, equipment, and techniques and intermediate to advanced proficiency in Microsoft office products (Word, Excel, Power Point, Outlook, Teams, etc.), and Vaya systems, to include the care management platform, data analysis, and secondary research</li><li>
Must be highly skilled at shifting between macro and micro level planning, maintaining both the big picture, and seeing that the details are covered.</li><li>
Ability to use higher-level clinical training and licensure to perform clinical assessments, drive positive outcomes for members, support care management colleagues, and offer clinical assistance to providers.</li><li>
Highly skilled at performing clinical assessments of members and identifying member needs.</li><li>
Extensive understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) within their scope and have considerable knowledge of the MH/SU/IDD/TBI service array provided through the network of Vaya providers.</li><li>
Experience and knowledge of the NC Medicaid program, NC Medicaid Transformation, Tailored Plans, state-funded services, and accreditation requirements are preferred.</li><li>
Ability to complete and maintain all trainings and proficiencies required by Vaya, however delivered, including but not limited to the following:<ul><li>
BH I/DD Tailored Plan eligibility and services</li><li>
Whole-person health and unmet resource needs (ACEs, trauma-informed care, cultural humility)</li><li>
Community integration (independent living skills; transition and diversion, supportive housing, employment, etc.)</li><li>
Components of Health Home Care Management (Health Home overview, working in a multidisciplinary care team, etc.)</li><li>
Health promotion (common physical comorbidities, self-management, use of IT, care planning, ongoing coordination)</li><li>
Other care management skills (transitional care management, motivational interviewing, person-centered needs assessment and care planning, etc.)</li><li>
Serving members with I/DD or TBI (understanding various I/DD and TBI diagnoses, HCBS, Accessing assistive technologies, etc.)</li><li>
Serving children (child-and family-centered teams, Understanding the &ldquo;System of Care&rdquo; approach)</li><li>
Serving pregnant and postpartum women with SUD or with SUD history</li><li>
Serving members with LTSS needs (Coordinating with supported employment resources</li></ul></li><li>
Job functions with higher consequences of error may be identified, and proficiency demonstrated and measured through job simulation exercises administered by the supervisor where a minimum threshold is required of the position.</li></ul><div></div><div><b><br>
EDUCATION &amp; EXPERIENCE REQUIREMENTS</b></div><p>
Master&rsquo;s degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area. <b>For incumbents with a Master&rsquo;s Degree in a Human Services Area besides Nursing, one of the following required years of experience:</b></p><div><ul><li><b>
Serving members with BH conditions:</b></li></ul></div><div><ul><li>
Two (2) years of experience working directly with individuals with BH conditions</li></ul></div><div><ul><li><b>
Serving members with LTSS needs</b><ul><li>
Two (2) years of prior Long-tern Services and Supports and/or Home Community Based Services coordination, care delivery monitoring and care management experience.</li><li>
This experience may be concurrent with the two years of experience working directly with individuals with BH conditions, an I/DD, or a TBI, described above</li></ul></li></ul></div><div></div><div><b><br>
For incumbents with a Master&rsquo;s Degree in Nursing, four years of full-time accumulated experience in mental health with the population served is required.</b> Experience can be before or after obtaining RN licensure.</div><div></div><ul><li><br>
<i>Must meet the criteria of being a North Carolina Qualified Professional with the population served in 10A NCAC 27G .0104</i></li></ul><div></div><div><b><br>
Licensure/Certification Required:</b></div><div>
Valid licensure required. Acceptable licenses are Registered Nurse (RN), Licensed Clinical Social Worker (LCSW), Licensed Clinical Social Worker Associate (LCSWA), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Clinical Mental Health Counselor Associate (LCMHCA), Licensed Clinical Mental Health Counselor Supervisor (LCMHCS), Licensed Psychological Associate (LPA), Health Services Professional Psychological Associate (HSP-PA), Licensed Clinical Addiction Specialist (LCAS), Licensed Clinical Addiction Specialist Associate (LCASA), Licensed Marriage and Family Therapist (LMFT) or Licensed Marriage Family Therapist Associate (LMFTA).</div><div></div><ul><li><br>
Due to the multi-disciplinary nature of the LME/MCO business, care managers must operate within their scope of practice, and must engage and leverage other disciplines outside of their own training and credentials.</li></ul><div></div><p><b><br>
Preferred Work Experience:</b></p><div><ul><li>
Experience working directly with individuals with I/DD or TBI</li></ul></div><div></div><div><b><br>
PHYSICAL REQUIREMENTS</b></div><ul><li>
Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.</li><li>
Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists, and fingers.</li><li>
Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.</li><li>
Mental concentration is required in all aspects of work.</li><li>
Ability to drive and sit for extended periods of time (including in rural areas)</li></ul><div></div><div><b><br>
RESIDENCY REQUIREMENT:</b> The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border.</div><div></div><div><b><br>
SALARY: </b>Depending on qualifications &amp; experience of candidate. This position is exempt and is not eligible for overtime compensation.</div><div></div><div><b><br>
DEADLINE FOR APPLICATION:</b> Open Until Filled</div><div></div><div><b><br>
APPLY:</b> Vaya Health accepts online applications in our Career Center, please visit https://www.vayahealth.com/about/careers/.</div><div></div><div><br>
Vaya Health is an equal opportunity employer.</div></div><div></div>

Care Manager - LP (McDowell County, NC)

Trillium Health Resources

<div><div><b>Pay Plan Title: </b>Care Manager</div><div><b>
Working Title: </b>Innovations Waiver Care Manager</div><div><b>
Cost Center: </b>8500/Plan Based Care Management</div><div><b>
FLSA Status: </b>Non-Exempt</div><div><b>
Posting Salary Range: </b>$54,106 - $67,210</div><div><b>
Office Location: </b>Remote within 75 miles of Trillium&rsquo;s Mid State Region (See requirements section for included counties)</div><div></div><div><b><br>
POSTING DETAILS:</b></div><div></div><div><b><br>
Make an Impact</b></div><div></div><div><br>
Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.</div><div></div><div><b><br>
Why Work for Us</b>?</div><div></div><div><br>
Trillium believes that empowering others begins with supporting our team. We offer our employees:</div><div></div><div><br>
<ul><li>
A collaborative, mission-driven work environment</li><li>
Competitive benefits and work-from-home options for most positions</li><li>
Opportunities for professional growth in a diverse inclusive culture</li></ul></div><div></div><div><br>
Every day, our work changes lives &ndash; from children thriving through early intervention and school-based therapies, to adults with severe mental illness living independently and contributing to their communities.</div><div></div><div><br>
If you are looking for a unique opportunity to make a tangible impact on the lives of others, apply today!</div><div></div><div><b><br>
What We&rsquo;re Looking For</b></div><div></div><div><br>
Trillium Health Resources has a career opening for an Innovations Waiver Care Manager to join our Care Management Team! The Innovations Wavier Care Manager is responsible for providing complex care coordination and monitoring to members having a primary Intellectual or Developmental Disability, which may include secondary mental health or substance abuse, and/or complex medical/physical health needs. This position requires a dynamic, proactive approach to assessment, monitoring, and complex coordination of care, to ensure quality support and consistent adherence to waiver requirements. Innovations Waiver Care Manager assists with integrated care management through multi-disciplinary collaboration and referrals. This position has a primary focus on members who have Intellectual Developmental Disability, serving both children, adolescents, and adults.</div><div></div><div><b><br>
On a typical day, you might:</b></div><div></div><div><br>
<ul><li>
Utilize person centered planning methods/strategies to gather information, to get to know the members supported and to adequately address specific needs of the individual.</li><li>
Provide education and support to members in learning about and exercising rights and responsibilities.</li><li>
Consistently complete Discovery activities (information gathering and assessment) as a component of the planning process.</li><li>
Ensure that members/legally responsible people are informed of services available (all types of Medicaid and state-funded services), service options available (e.g. Individual/Family Direction for Innovations participants), processes (e.g. requirements for specific service), Natural and community services, and so forth.</li><li>
Assist members/legally responsible people in choosing service providers, ensuring objectivity in the process.</li></ul></div><div></div><div><b><br>
Employee Benefits:</b></div><div></div><div><br>
Trillium knows that work/life balance is essential. That&rsquo;s why we offer:</div><div></div><div><br>
<ul><li>
Typical working hours: 8:30 am &ndash; 5:00 pm; flexible work schedules with some roles with management approval.</li><li>
Work-from-home options available for most positions</li><li>
Health Insurance with no premium for employee coverage</li><li>
Flexible Spending Accounts</li><li>
24 days of Paid Time Off (PTO) plus 12 paid holidays in your first year</li><li>
NC Local Government Retirement Pension (defined-benefit plan) https://www.myncretirement.gov/systems-funds/local-governmental-employees-retirement-system-lgers/lgers-handbook</li><li>
401k with 5% employer match and immediate vesting</li><li>
Public Service Loan Forgiveness (PSLF) qualifying employer</li><li>
Quarterly stipend for remote work supplies</li></ul></div><div></div><div><b><br>
Qualifications</b></div><div></div><div><br>
Required:</div><div><ul><li>
Must meet QP status.</li></ul></div><div><ul><li>
Fully licensed by the NC governing board regulating Human Services professions; <b>OR</b> Fully licensed RN who is licensed to practice in the state of NC by the NC Board of Nursing who also has four (4) years of full-time experience with the MH/DD/SA population served. <b>OR</b></li><li>
A graduate of a college or university with a Master&rsquo;s degree in a human service field and has one year of full-time, pre or post-graduate degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has one year of full-time, pre or postgraduate degree accumulated supervised experience in alcoholism and drug abuse counseling; <b>OR</b></li><li>
A graduate of a college or university with a bachelor's degree in a human service field and has two years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has two years of full-time, pre or post bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling; <b>OR</b></li><li>
A graduate of a college or university with a bachelor's degree in a field other than human services and has four years of full-time, pre or post-bachelor's degree accumulated MH/DD/SA experience with the MH/DD/SA population, or a substance abuse professional who has four years of full-time, pre or post-bachelor's degree accumulated supervised experience in alcoholism and drug abuse counseling.</li></ul></div><div><ul><li>
Additionally, If serving members with LTSS needs, the care manager, must meet the minimum QP requirements defined above (A-D) and shall additionally have at a minimum two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience. This experience may be concurrent with the years of experience required to become a Qualified Professional.</li><li>
License and/or certification may be accepted as noted above.</li><li>
Must have a valid driver&rsquo;s license.</li><li>
Must reside in North Carolina and within 75 miles of the following Mid-State Trillium counties: Guilford.</li><li>
Must be able to travel within catchment as required.</li></ul></div><div></div><div><b><br>
Deadline for Application:</b> Position will remain open until filled</div><div></div><div><b><br>
How to Apply</b></div><div></div><div><br>
To be considered, submit your application and resume through our ADP Career Center. Your resume must include:</div><div></div><div><br>
<ul><li>
Employer name, dates of service (month/year), average hours worked per week, and essential job duties</li><li>
Education details (degree type, date awarded, institution, field of study)</li><li>
Licensure/certification information, if applicable</li></ul></div><div></div><div><br>
After submission, your resume will be reviewed to ensure it meets the essential criteria for the position. You&rsquo;ll be notified by HR regarding your application status as appropriate. All applicants will receive a final update once the recruitment cycle closes.</div><div></div><div><br>
Join our Talent Community through ADP to stay informed about future opportunities. Be sure to keep your resume updated in your profile.</div><div></div><div><b><br>
Trillium Health Resources is an Equal Employment Opportunity (EEO) employer and a drug-free workplace. All candidates must pass a drug test as a condition of employment.</b></div><div></div><div><i><br>
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Innovations Waiver Care Manager

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