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Embedded Care Manager
2 months ago
Vaya Health is seeking a highly skilled Embedded Care Manager to join our team. As a key member of our care management team, you will be responsible for providing proactive intervention and coordination of care to eligible Vaya Health members and recipients. Your primary goal will be to ensure that these individuals receive appropriate assessment and services to meet their unique needs.
Key Responsibilities- Conduct comprehensive assessments of members' needs, including behavioral health, medical, and social determinants.
- Develop and implement person-centered care plans that address members' goals and priorities.
- Collaborate with members, care teams, and community stakeholders to ensure seamless care coordination and transitions.
- Provide education and support to members and their families on health promotion, disease management, and self-care strategies.
- Facilitate shared case staffing with DSS social workers, behavioral health providers, and Vaya care management to proactively plan for and communicate care needs.
- Participate in interdisciplinary care team meetings, comprehensive care planning, and ongoing care management to ensure members receive comprehensive and coordinated care.
- Monitor provision of services to informally measure quality of care delivered by providers and identify potential non-compliance with standards.
- Ensure 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.
- Bachelor's degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services area.
- Two years of experience working directly with individuals with behavioral health conditions, or two years of prior long-term services and supports (LTSS) and/or home community-based services (HCBS) coordination, care delivery monitoring, and care management experience.
- Must meet the criteria of being a North Carolina Qualified Professional with the population served in 10A NCAC 27G.0104.
- Licensure/Certification Required: If incumbent has a Bachelor's degree in nursing and RN, incumbent must be licensed by the North Carolina Board of Nursing to practice in the State of North Carolina.
- Experience working directly with individuals with intellectual and developmental disabilities (I/DD) or traumatic brain injury (TBI).
- Knowledge of the Diagnostic and Statistical Manual of Mental Disorders (current version) and the MH/SU/IDD/TBI service array provided through the network of Vaya providers.
- Experience and knowledge of the NC Medicaid program, NC Medicaid Transformation, Tailored Plans, state-funded services, and accreditation requirements.
This position requires close visual acuity to perform activities such as preparation and analysis of documents, viewing a computer terminal, and extensive reading. Physical activity includes crouching, reaching, walking, talking, hearing, and repetitive motion of hands, wrists, and fingers. Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time. Mental concentration is required in all aspects of work.
Residency RequirementThis position is required to reside in North Carolina or within 40 miles of the North Carolina border.
SalaryDepending on qualifications and experience of candidate. This position is non-exempt and is eligible for overtime compensation.
