Registered Nurse CAP Case Manager / RN / FT / Buncombe Area / Flexible Area
$3,000 Sign-On Bonus
We are hiring for a Registered Nurse CAP Case Manager who will collaborate with the CAP Social Worker, families, healthcare providers, and service providers to ensure the health, safety, and well‑being of program participants.
Duties and Responsibilities
Assessment and Care Planning:
Conduct initial pre‑screening and assessments of beneficiaries and their families.
Consult with the CAP beneficiary and primary caregiver to educate about waiver services, Medicaid, and community resources.
Identify needs to prevent health and safety factors and maintain community placement.
Develop and maintain individualized, person‑centered care plans (including emergency and disaster planning).
Update care plans at least every 12 months or when the beneficiary’s status changes.
Ensure beneficiaries and families understand the plan of care for informed decision‑making.
Service Coordination:
Coordinate services such as personal care, waiver supplies, home modifications, and educational support in alignment with the care plan.
Collaborate with the team to monitor service quality and ensure compliance with Medicaid and program standards.
Arrange for additional services as needed to prevent institutionalization and support participants in their homes.
Monitoring and Follow‑Up:
Monitor services through monthly phone calls and home visits, documenting observations and beneficiary progress.
Evaluate the effectiveness of care plans and services, recommending or implementing changes as needed to achieve desired outcomes.
Counseling and Support:
Provide emotional support and counseling to beneficiaries and their families.
Assist families in navigating challenges, including long‑term palliative care, behavioral issues, and medical needs.
Documentation and Compliance:
Assist with obtaining documentation from medical staff to confirm the need for specific CAP services.
Maintain accurate and up‑to‑date records for all participants in accordance with Medicaid and program requirements.
Ensure compliance with 10A NCAC 27G.0202 and other regulatory guidelines.
Review and ensure proper billing codes and compliance for case management, in‑home aide documentation, paid live‑in caregiver, re‑certifications, and supply billing.
Participate in NC Medicaid‑certified training programs and ensure program compliance within 90 days of employment.
Ensure timely updates to the CAP Business system and other documentation systems as required.
Collaboration and Advocacy:
Work closely with SWs and interdisciplinary team members to ensure a comprehensive approach to beneficiary care.
Act as an advocate for program participants and their families to secure necessary resources and services.
Work closely with service providers, community agencies, and healthcare professionals to optimize care outcomes.
Provide training and support to families to empower them in managing their child’s care.
Continuing Education and Professional Development:
Complete all state‑mandated training and agency‑required continuing education annually.
Stay current on CAP guidelines, best practices, and new developments to enhance service delivery.
All other duties as assigned.
Supervisory Responsibilities
This position has no supervisory responsibilities.
Minimum Qualifications
Strong understanding of Medicaid programs and compliance requirements.
Excellent communication and interpersonal skills to work effectively with families and multidisciplinary teams.
Ability to manage multiple priorities and maintain detailed records.
Experience working with medically fragile children or in pediatric healthcare settings and physically disabled adults with complex care needs.
Education and Experience
Candidates must meet one of the following criteria:
Nursing Background
Current North Carolina Registered Nurse (RN) license with a two‑year or four‑year degree.
One year of case management experience in home care, long‑term care, personal care, or related work.
Completion of an NC Medicaid‑certified training program within 90 calendar days of employment.
An individual with a bachelor’s degree or who holds a nursing license as described above, without the number of years of experience, may be designated as an apprentice and shall be hired to act in the role of case manager. The supervisor of the case management shall provide direct supervision and approve all CAP/C workflow documentation and tasks.
Physical Demands and Work Environment
Must be able to lift a minimum of 10 lbs.
Must be able to pull a minimum of 20 lbs.
Must be able to squat, kneel, crawl, crouch, climb, and stoop.
Required to regularly stand and walk.
Employment and Benefits
We offer the following benefits to employees: Payactiv, employee perks and discount program, paid time off (full‑time employees only), health/insurance (full‑time employees only), 401(k) retirement savings program, wellbeing programs, chronic disease management programs, training, and more.
EEO Statement
RHA is an equal opportunity employer. RHA is an Equal Employment Opportunity Employer, prohibits discrimination based on race, creed, color, national origin, nationality, ancestry, age, sex/gender, marital status, civil status, domestic partnership status, familial status, religion, affectional or sexual orientation, gender identity or expression, atypical hereditary cellular or blood trait, genetic information, liability for service in the Armed Forces of the United States, or disability.
Pre‑Employment Screening
Complete criminal background check.
Name checked in registries.
Drug testing.
Education verification and other credentialing based on position requirements.
Proof of employment history or references, if required.
Positions requiring driving proof of driver's license, insurance, and vehicle, if required for transportation.
About RHA
At RHA Health Services, we help individuals with intellectual and developmental disabilities, mental health and/or substance use needs live their best lives. Our mission is to provide a safe and healthy environment while creating opportunities for personal outcomes. For over 30 years, the people we serve have remained at the very center of everything we do. RHA currently provides services in North Carolina, Georgia, Pennsylvania, Tennessee, and New Jersey.
Apply Today
If you are ready to make a difference in the lives of people we serve and support, apply to join the team today.