Care Manager II-Facility Based (Full time, Mecklenburg County, North Carolina Based)

The Care Manager II-Facility Based provides Transitional Care Management and Physical Health Consultation for members with physical and/or behavioral health needs in Acute Care facilities, State Operated Developmental Centers, and Justice System settings. For Care Manager II-Facility Based assigned to a facility, there will be active and onsite participation in discharge planning beginning with admission. This is a full-time hybrid opportunity. There is no expectation of coming into the office routinely, however, the selected candidate must be available to report onsite to the Alliance Office (Charlotte, North Carolina) for business meetings as needed. The successful candidate will also be required to travel at least weekly throughout Mecklenburg to meet with members, providers and/or other community stakeholders in a hospital setting. Responsibilities & Duties Provide Care Team SupportSupport members transitioning from inpatient settings to the appropriate and least restrictive lower or lateral level of careProvide subject matter expertise, within scope, regarding member's physical and/or behavioral 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 communities and address barriers Core Transitional Care Management FunctionsConducts on site visit the member during their stay in an institution (e.g., acute, subacute and long-term stay facilities)Conduct outreach to the member's providersObtain a copy of the discharge plan ensure discharge plan is made available to authorized community providers who will be serving the member post dischargeFacilitate clinical handoffs to other Health Plans and Providers as applicableRefer and assist members in accessing needed social services and supports identified as part of the transitional care management process, including access to housing, behavioral health services, residential services and supports, medical and wellness servicesAssist the member in obtaining needed medications prior to discharge, ensure an appropriate care team member conducts medication reconciliation/management and support medication adherenceDevelop a ninety (90) day post-discharge transition plan prior to discharge from residential or inpatient settings, in consultation with the member, facility staff and the member's care team, that outlines how the member will maintain or access needed services and supports, transition to the new care setting, and integrate into their communityCommunicate and provide education to the member and the member's caregivers and providers to promote understanding of the ninety (90) day post-discharge transition planAssist with scheduling of transportation, in-home services, and follow-up outpatient visits with appropriate providers within a maximum of seven (7) Calendar Days post-discharge, unless required within a shorter timeframeConduct In reach and transitions for Special Populations receiving care in Inpatient settings (PRTF, SNF's) Monitoring/CoordinationAppropriately 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 and follow escalation protocols to ensure timely engagement from members or our Medical Team and Provider NetworksObtain information releases that will improve care management activities on behalf of the memberReports care quality concerns to Quality Management as needed DocumentationEnsure all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency, and Medicaid requirementsFollow administrative procedures and effectively manages caseload DataReview, 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 disciplines TravelTravel between Alliance offices, attending meetings on behalf of Alliance, participating in Alliance sponsored events, etc. may be requiredTravel to meet with members, providers, stakeholders, attend court hearings etc. is required Minimum Requirements Education & Experience Required: Graduation from an accredited school of Nursing and three (3) years of full-time, post degree experience providing care management, case management, care coordination, discharge planning, or utilization management to members with Behavioral Health and Physical Health conditions in a behavioral health, medical, or managed care setting. Must have a valid, active RN license in North Carolina. Or Master's degree from an accredited college or university in Human Services or related field and at least two (2) years of full-time, post graduate degree experience providing care management, case management, care coordination, discharge planning, or utilization management to members with Behavioral Health and Physical Health conditions in a behavioral health, medical, or managed care setting. Must have a valid, active clinical license (LCSW, LMFT, LCAS, LCMHC, LPA) in North Carolina. Knowledge, Skills, & AbilitiesA demonstrated 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/planningThe employee must be detail 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 - $86,990/ Annual Exact 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, Long Term DisabilityGenerous retirement savings planFlexible work schedules including hybrid/remote optionsPaid time off including vacation, sick leave, holiday, management leaveDress flexibility Employment for this position is contingent upon a satisfactory background and MVR (Motor Vehicle Registration) check, which will be performed after acceptance of an offer of employment and prior to the employee's start date. Want to learn more about what it's like work as part of the Care Management Team? Click on our video to learn more: https://youtu.be/1GZOBFx61QU Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.