LOCATION: Remote - must live in or near Rockingham County, North Carolina. The person in this position is required to maintain residency in North Carolina or within 40 miles of the NC border. This position requires travel within these counties.
GENERAL STATEMENT OF JOB
The Care Manager Licensed Professional (Care Manager - LP) is responsible for providing proactive intervention and coordination of care to eligible Vaya Health members and recipients (members) 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 (I/DD), traumatic brain injury (TBI) physical health, pharmacy, long-term services and supports (LTSS) and unmet health-related resource needs networks.
As further described below, essential job functions of the Care Manager - LP include, but may not be limited to:
Utilization of and proficiency with Vaya's Care Management software platform/administrative health record (AHR)
Outreach and engagement
Compliance with HIPAA (Health Insurance Portability and Accountability) requirements, including Authorization for Release of Information (ROI) practices
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
Adherence to Medication List and Continuity of Care processes
Participation in interdisciplinary care team meetings, comprehensive care planning, and ongoing care management
Transitional Care Management
Diversion from institutional placement
ESSENTIAL JOB FUNCTIONS
Clinical Assessment, Care Planning, and Interdisciplinary Care Team:
Ensures identification, assessment, and appropriate person-centered care planning for members.
Links members with appropriate and necessary formal/informal services and supports across all health domains (i.e., medical, and behavioral health home)
Meets with members to conduct the HRA and gather information on their overall health, including behavioral health, developmental, medical, and social needs.
Administers the PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other screenings based on member's needs.
Supports the care team in development of a person-centered care plan (Care Plan) 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.
Collaboration, Coordination, Documentation:
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.
Executes independent discretion and engages in business decisions for the Vaya Care Management Department that support initiatives to promote Vaya's integrated, whole-person care model for members.
Serves as a collaborative partner in identifying system barriers through work with community stakeholders.
KNOWLEDGE, SKILLS, & ABILITIES
Ability to express ideas clearly/concisely and communicate in a highly effective manner
Ability to drive and sit for extended periods of time (including in rural areas)
Exceptional interpersonal skills and ability to represent Vaya in a professional manner
Ability to initiate and build relationships with people in an open, friendly, and accepting manner
EDUCATION & EXPERIENCE REQUIREMENTS
Master's degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area.
Serving members with BH conditions: Two (2) years of experience working directly with individuals with BH conditions
Serving members with LTSS needs: Two (2) years of prior Long-term Services and Supports and/or Home Community Based Services coordination, care delivery monitoring and care management experience.
Licensure/Certification Required:
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).
Vaya Health is an equal opportunity employer.