TCL Complex Care RN Evaluator (Full-time Hybrid, Charlotte, North Carolina Based)

The TCL Complex Care RN Evaluator shall provide physical health and functional assessments and transition planning assistance primarily for TCL members transitioning from Adult Care Homes (ACHs), and to the extent capacity allows, to TCL members transitioning from other settings, with complex medical and/or functional conditions that significantly impede the transition of the member into the community (severity is determined by the PIHP screening process).This position will require extensive travel and may include visits with members in Adult Care Homes and member living in the community. One day a week is required onsite at the Mecklenburg office in Charlotte, NC.Responsibilities & DutiesProvide Care Team SupportSupport members transitioning from institutional care settings to community-based careProvide subject matter expertise, within scope of license, regarding member's physical health to support the development and delivery of a whole person approach to Care ManagementWork collaboratively with other Alliance staff, behavioral health providers, primary care physicians, specialty care providers and other community partners and stakeholders to support members in their home communitiesComplete Assessments and PlanningUtilize person-centered planning, motivational interviewing, and assessments to gather informationPerform individual assessments/screenings for members that are medically fragile or have significant health conditions, have a mental health condition, substance use condition, or co-occurring intellectual or developmental disabilityIn the Transition and Housing setting, staff will also assess and record member's activities and progressProvide education and supports to members and/or legal guardians regarding self-care strategies, their rights and responsibilities, available treatment options, provider network availability and payor requirements that may impact service access or maintenanceEducate team members about impact of member's health conditions on service engagement, clinical outcomes, and prognosis for changeActively collaborate with member and care team members to ensure care plan accurately reflects the individual's clinical needs and desired life goalsUpdate Assessments and plans of care as neededProvide education about advanced directives, preferred natural support and physical health contacts whom the member identifies, and preferred crisis facilitiesProvide medication reconciliation and educationDevelop and update plans of care based off the needs identified in the assessments and complete the interventions identified as neededReview member's medical history and identify specific goals and types of activities that will be used to help member work to help work towards those specific goalsProactively works with the member's multidisciplinary care team to identify gaps in services and intervenes to ensure that the member is receiving the appropriate level of careAssess members' homes to identify necessary modifications or durable medical equipment based on individual needs and provide instruction on the proper use of recommended equipmentMonitoring/CoordinationProvide ongoing support for 90 days following the member's move, offering guidance and recommendations to help reduce crisis service or inpatient utilization and support long-term housing stabilityAppropriately escalate high risk/high visibility and/or complex barriers/needs members who may have difficulty transitioning out of the facility in a timely manner to supervisors. High risk can involve Health and Safety of a member, staff, or organizational riskReview cases with clinical complexity with direct supervisor, peer clinical review cohort, and utilization management care managers and medical management leadership as neededObtain information releases that will improve care management activities on behalf of the memberReports care quality concerns to Quality Management as neededDocumentationEnsure all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency, and Medicaid requirementsFollow administrative procedures and effectively manages caseloadDataReview, validate and interpret risk stratification data and population health groups and recommend changes or adjustments to care management approach as neededUtilize data to analyze needs of the members we serve, guide staff training development, identify resource needs and consistency of workflow implementation across disciplinesTravelTravel between Alliance offices, attending meetings on behalf of Alliance, participating in Alliance sponsored events, etc is required for member facing visits in the ACH and/or other community based settingsTravel to meet with members, providers, stakeholders, attend court hearings etc. is requiredMinimum RequirementsEducation & ExperienceRequired:Graduation from a school of nursing and two (2) years of full-time nursing experience with the population served and active NC or Compact Registered Nurse License.Preferred:Home & Community based serviceKnowledge, Skills, & AbilitiesDemonstrated knowledge of the assessment and treatment of mental health, substance abuse, intellectual and developmental disabilities,Knowledge of legal, waiver, accreditation standards and program practices/requirements.Knowledge of the Alliance Health service benefit plans and network providers.Person Centered Thinking/planningDetail oriented,Ability to independently organize multiple tasks, priorities, and to effectively manage an assigned caseload under pressure of deadlines.Exceptional interpersonal skills, highly effective communication ability,Ability to make prompt independent decisions based upon relevant facts and established processes.Problem solving, negotiation and conflict resolution skillsProficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) is required.Salary Range$68,227 -$88,695/AnnuallyExact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.An excellent fringe benefit package accompanies the salary, which includes:• Medical, Dental, Vision, Life, Short and Long- and Short-Term Disability• Generous retirement savings plan• Flexible work schedules including hybrid/remote options• Paid time off including vacation, sick leave, holiday, management leave• Dress flexibilityEqual Opportunity EmployerThis employer is required to notify all applicants of their rights pursuant to federal employment laws.