IDD Specialty Care Manager Lead

IDD Specialty Care Manager Lead

We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system so that they receive seamless, integrated, and coordinated health care. Within the Children and Families Specialty Plan (CFSP), and regardless of where a member lives, they will have access to the same basic benefits and services, including physical health, behavioral health, pharmacy, intellectual/developmental disabilities (I/DD) services, long term services and supports, unmet health-related resource needs, and integrated care management. We envision a North Carolina where all children and families thrive in safe, stable, and nurturing homes.

North Carolina residency is required! We are currently seeking people throughout the State of North Carolina in the following DSS Regions:

• Region 1 counties: Buncombe, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, Mitchell, Polk, Swain, Transylvania, Yancey
• Region 2 counties: Alexander, Alleghany, Ashe, Avery, Burke, Caldwell, Catawba, Cleveland, Gaston, Iredell, Lincoln, McDowell, Rutherford, Watauga, Wilkes
• Region 3 counties: Alamance, Caswell, Chatham, Davidson, Davie, Durham, Forsyth, Guilford, Orange, Person, Randolph, Rockingham, Stokes, Surry, Yadkin
• Region 4 counties: Anson, Cabarrus, Harnett, Hoke, Lee, Mecklenburg, Montgomery, Moore, Richmond, Robeson, Rowan, Scotland, Stanly, Union
• Region 5 counties: Edgecombe, Franklin, Granville, Halifax, Johnston, Nash, Northampton, Pitt, Vance, Wake, Warren, Wayne, Wilson, Greene
• Region 6 counties: Bladen, Brunswick, Carteret, Columbus, Craven, Cumberland, Duplin, Jones, Lenoir, New Hanover, Onslow, Pamlico, Pender, Sampson
• Region 7 counties: Beaufort, Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Hyde, Martin, Pasquotank, Perquimans, Tyrrell, Washington

Travel within your assigned DSS Region is required. When you are not in the field, you will work virtually from your home. These roles are statewide field-based and requires you to interact with patients, members, or providers 10-20% of the time. This is a collaborative role with the field care managers for the CFSP program with the advisors supporting the care managers with consulting on IDD cases. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.

The IDD Specialty Care Manager Lead is responsible for coordinating operations and workflows related to Intellectual, Developmental & Disability - IDD case management activities in support of CFSP Foster Care. Serve as coach. Performs case management telephonically and/or by home visits within the scope of licensure. Manages overall healthcare costs for the designated population via integrated (physical health/behavioral health) case management and whole person health. Manages the most complex cases and provides support to Special Programs case managers.

How you will make an impact:

• Engage collaboratively with key stakeholders, including families, foster parents, and service teams to craft and sustain individualized treatment plans.
• Conducts assessments to identify individual needs.
• Develops comprehensive care plan to address objectives and goals as identified during assessment.
• Supports member access to appropriate quality and cost effective care and modifies plan(s) as needed.
• Coordinates with internal and external resources to meet identified needs of the member in terms of integrated (physical and behavioral) whole person care.
• Coordinates social determinants of health to meet the needs of the member and incorporates that into care planning.
• Works closely with various state agencies.
• Maintains knowledge of the system of care philosophy; a spectrum of effective, community-based services and supports for those with or at risk for mental health or other challenges and their families, that is organized into a coordinated network.
• Builds meaningful partnerships with designated populations and their families, and addresses cultural and linguistic needs, in order to help them function better at home, in the community, and throughout life.
• Evaluates health needs and identifies applicable services and resources in conjunction with members and their families.
• Provides important information including patient education, medication reconciliation, and identification of community resources and assists with arrangement of follow-up care.
• Facilitates health rounds with other clinical centered professionals to ensure whole person health.
• May lead and work on specialty projects and initiatives.
• Assists with process improvements activities.
• Trains and mentors staff.
• Performs case/chart audits and ensures departmental compliance.
• Serves as a member of the leadership team.

Minimum Requirements:

• Requires MS/MA in social work, counseling, or a related behavioral health field or a degree in nursing and minimum of 7 years of clinical experience in social work counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background.
• Requires an active, current and valid license as an RN, LCSW (as applicable by state law and scope of practice), LMHC, LPC (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.

Preferred Skills, Capabilities, and Experiences:

• Experience working with Children, Youth, and Families who are being served by Local Departments of Social Services through Foster Care and Adoptive Assistance programs is strongly preferred.
• Experience serving the children and youth involved in Foster Care and Social Services.
• Knowledge of resources, supports, services and opportunities required for safe community living for populations receiving in-reach and transition services, including LTSS, Behavioral Health, therapeutic, and physical health services.
• Service delivery coordination, discharge planning or behavioral health experience in a managed care setting preferred.
• Travels to worksite and other locations as necessary.
• Clinical experience in social work counseling with a broad range of complex psychiatric/substance abuse and/or medical disorders preferred.
• Experience working with specialty populations preferred.
• Certified Case Manager Certification preferred.
• We are unable to accommodate LCSW-A, LCMHC-A or any other associate level licenses.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color