Care Manager

ResCare Community Living

Work in conjunction with diverse clinical teams and utilize community resources to meet the needs of individuals receiving care management services. Provide services in accordance with care management service requirements set by the state and company. Responsible for developing and monitoring Tailored Care Management care plans and Individual Support Plans (ISPs) built from comprehensive assessments to an assigned caseload.

• Develops positive relationships among and between members family/guardians Extenders clinical and care team members and other community stakeholders to create an environment of compassion and professionalism driving toward positive health and quality of life outcomes.
• Responds proactively to alerts from Extenders concerning unmet health-related needs and identified barriers and gaps to reduce adverse health and quality of life indicators.
• Develops positive relationships with all funding sources that exhibits the willingness to obtain common objectives related to care management.
• Engages the member/family/guardian to establish rapport and provide required and as needed contact ensuring service provision is up to date and follow through is completed.
• In conjunction with the member selects members for the care team (adjusting as needed).
• Conducts the Comprehensive Health Assessment on the member with stakeholder input to obtain baseline information needed to formulate a care plan.
• Coordinates schedules sets the agenda for and assists the member in chairing care team meetings (times dates locations etc.) and informs all team members.
• Develops implements reassesses oversees the implementation of and evaluates the Care Plan/ISP for the member to ensure that the members health needs are addressed in a comprehensive holistic and preventive manner with quality as a goal.
• Manages care transitions and transition plans.
• Ensures medication monitoring and reconciliation occur.
• Monitors/implements/supervises delivery of service plans and personal futures plan and training of staff.
• Documents all information gathered/received electronically in a timely manner.
• Provides documentation of billable events that align with minimum contact expectations to the Care Management Supervisor.
• Maintains an accurate up-to-date electronic information data stream on all interactions encounters activities care team meetings and communications with the member/family/guardian.
• Promotes and coordinates comprehensive care among medical pharmaceutical psychosocial social mental physical home health ancillary providers and other community agencies supporting individuals with referrals as needed.
• Connects members with medical mental developmental psychosocial housing transportation home health and community support services/systems to achieve a comprehensive holistic preventive approach.
• Empowers the member/family/guardian and other team members with knowledge that aids in implementing the care plan treatment plan medication regimen and appointment keeping.
• Identifies barriers gaps and unmet health-related needs are addresses them proactively expanding relationships and linkages to aid in meeting members needs.
• Supervises up to two FTEs of care management extenders.
• Provides services that meet national state and local healthcare standards at the highest level.
• Reports issues of concern general departmental activities and staffing needs to the Care Management Supervisor.

• Completes all required training and participates in educational sessions to improve overall skills.

• Attends industry meetings training and functions to promote positive relationships with stakeholders.

• Participates in quality improvement and measurement activities to achieve identified targets and outcomes.

• Completes other duties as assigned.

Qualifications:

• Years of experience as specified below.
• Two years of experience as a Care Manager Case Manager or Care Coordinator preferred.
• Ability to perform work with a high degree of quality and autonomy.
• Must meet all agency requirements for pre-employment and those required by the state of NC.

Education:

• A license provisional license certificate registration or permit issued by the governing board regulating a human service profession except a registered nurse who is licensed to practice in the State of North Carolina by the North Carolina Board of Nursing who also has four years of full-time accumulated experience with the IDD population; or
• A Masters degree in a human service field and one year of full-time post-graduate degree accumulated experience with the IDD population; or
• A bachelors degree in a human service field and two years of full-time post-bachelors degree accumulated experience with the IDD population; or
• A bachelors degree in a field other than human services and four years of full-time post-bachelors degree accumulated experience with the IDD population; and

For care managers serving members with LTSS needs: two years of prior LTSS and/or HCBS coordination care delivery monitoring and care management experience in addition to the requirements cited above. (This experience may be concurrent with the two years of experience working directly with individuals with I/DD or a TBI above.)