Excellent Benefit Package to Include:

• Employer paid Health, Dental, Life and Long Term Disability Insurance
• NC Local Government Retirement System
• NC 401K with 4% employer match
• 12 paid holidays per year
• Monthly sick and vacation leave earnings

Position: I/DD Care Manager

Category: Non-Exempt

Location: Remote - Must reside in North Carolina

Salary Range: $41,026 - $56,555

Closing Date: Until Filled

Position Number: Multiple Positions

Primary Purpose of Position: The IDD/TBI Care Manager position is part of a multidisciplinary care team that is responsible for providing comprehensive assessment, care management and monitoring (treatment planning case management) which may include a co-occurring physical health, mental health (MH), substance use disorder (SUD), long-term services and supports (LTSS) and/or pharmacy needs. This position requires a dynamic, proactive approach to assessment, education, monitoring and coordination of care, to ensure quality supports and consistent comprehensive adherence to waiver requirements. The I/DD Care Manager supports members in managing their complete health (I/DD, MH/SUD, Physical Health, Social Determinants). Travel is an essential function of this position.

Responsibilities and Duties:

Assessment and Planning:

 Completion of comprehensive assessment

 Utilizes person centered planning methods/strategies to gather information and to get to know the members supported

 Consistently completes discovery activities (information gathering and assessment) in advance of the planning meeting

 Ensures that members/legally responsible persons are informed of services available, service options available (e.g. Individual/Family Direction for Innovations participants), processes (e.g. requirements for specific service), etc.

 Assists members/legally responsible persons in choosing service providers, ensuring objectivity

 Facilitate referrals for clinically indicated services (e.g., I/DD services, physical health services, community navigator to assist in social service need, mental health specialty care, substance abuse)

 Assists the members supported to direct the planning process/plan development, to the extent desired by the member

 Facilitates timely development of the ISP (Individual Support Plan), crisis plan, Risk Support Needs Assessment, and Behavior Support Plan (as applicable)

 Actively collaborates with members supported and members of the treatment team to ensure development of a comprehensive plan that reflects the member’s needs and desired life goals

 Promotes use of natural/community resources through the assessment/planning process

 Ensures that assessments/plans are updated, as needed, whenever the member’s life circumstances change

 Ensures needed community-based resources and social support needs are addressed in participant’s ISP

Support Monitoring/Coordination:

 Monitors services on site, in all settings and on a schedule outlined in the participant’s ISP.

 Closely coordinates care with the member’s IDD/TBI providers, physical health provider(s) and, when appropriate, behavioral health providers

 Supports psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment, ensures that services are monitored (including direct observation of service delivery) in all settings

 Makes announced/unannounced monitoring visits, including nights/weekends as applicable

 Monitors services for compliance with state standards, waiver requirements, and Medicaid regulations

 Recognizes and reports critical incidents

 Promotes member satisfaction through communication and timely follow-up on any concerns/issues

 Participates in Case Reviews/staffing with supervisor, IDD Clinical Directors, and/or Medical Directors

Comprehensive Transitional Care and Follow-Up:

 Management of transitions of care for members moving from one clinical setting to another to prevent unplanned or unnecessary readmissions, ED visits, or adverse outcomes

 Ensures comprehensive transition planning to ensure that members will maintain, or access needed services and supports, transition to the new care setting, and integrate into their community

 Management of care transitions (e.g. provider changes, implementation of new service, critical staffing changes, etc) to prevent adverse outcomes

 Facilitates member engagement and follow-up care

 Ensures accurate, timely and effective communication is both obtained and provided to all parties involved in care transitions

Individual and Family Support:

 Training the member in self-management

 Providing education and guidance on self-advocacy to the member, family members and support members

 Connecting the member and caregivers to education and training to help the member improve function, develop socialization and adaptive skills, and navigate the service system

 Providing information and connections to needed services and supports including but not limited to self-help services, peer support services and respite services

 Providing information to the member, family members and support members about the member’s rights, protections, and responsibilities, including the right to change providers, the Grievance and complaint resolution process, and fair hearing processes

 Health promotion, including promoting wellness and prevention programs

 Providing information on establishing Advance Directives, including advance instructions for mental health treatment, as appropriate, and guardianship options/alternatives, as appropriate

 Connecting members and family members to resources that support maintaining employment, community integration and success in school, as appropriate

Documentation and Fiscal Accountability:

 Educates members/families on methodology for budget development, total dollar value of the budget and mechanisms available to modify the individual budget. Educates the member/families on waiver requirements/limits however, ensures services, as requested are outlined in the budget.’

 Verifies that services are delivered as outlined in person centered plan and addresses any deviations

 Ensures that service orders/doctor’s orders are obtained, as applicable

 Proactively responds to a member’s planned movement outside the LME/MCO geographic area to ensure changes in their Medicaid County of eligibility are addressed prior to any loss of service

 Coordinates Medicaid deductibles, as applicable, with the member/legally responsible person and provider(s)

 Proactively monitors documentation/billing to ensure that issues/errors are resolved as quickly as possible

 Ensures accurate/timely submission of authorization requests for all LME/MCO-funded services/supports, as applicable

 Ensures all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency and Medicaid requirements

Other:

 This is a remote working position, with work done in a variety of locations and a considerable amount of time in the field

Education/Experience/Licensure:

 Bachelor’s degree in a human service field and two (2) years of experience working directly with individuals with I/DD or TBI. If working with a member with LTSS needs, the care manager must have two (2) years of prior Long Term Support Services and/or Home and Community Based Standards coordination, care delivery monitoring and care management experience. This experience may be concurrent with the two years of experience working directly with individuals with behavioral health conditions, an I/DD, or a TBI, as described above.

 Or Bachelor’s degree in a non human service field and four (4) years of experience as noted above.

The position will be remote but may need to come on site as needed. Must reside in North Carolina.