Geriatric Care Manager remote jobs - 222 jobs

When you join the team at Unum, you become part of an organization committed to helping you thrive. Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys opportunities to succeed both professionally and personally.

Benefits: Job you will love Fulfilling work Rewarding Career Supportive Environment Make a difference for your clients In Demand The Care Manager is responsible for providing quality professional care management services to all clients and their responsible parties. Our objective is to assist our clients in managing and navigating challenges in aging as well as Adults with physical and mental disabilities and providing the highest quality of life. This includes: Care Coordination Managing home health aides Medical oversight Interfacing with medical personnel Advocacy, information and referrals Qualifications: Professional and positive approach, commitment to customer service Self-motivated and work with own initiative Strong in building relationships, team player and able to communicate at all levels Recognizes industry trends and problem solves Respectful of company and client confidentiality; any violation of company or client confidence is immediate grounds for dismissal. Personalized and compassionate service - focusing on the individual client's wants and needs. Ability to provide non-directive guidance and facilitate constructive relationships. Ability to ensure inappropriate placements, duplication of services, and unnecessary hospitalizations are avoided. Manage time efficiently. Ability to provide coordinated communication between family members, doctors and other professionals, and service providers. This is a remote position. Aging Life Care Professionals offer a holistic, client-centered approach to caring for older adults or others facing ongoing health challenges. Working with families, the expertise of Aging Life Care Professionals provides the answers at a time of uncertainty. Their guidance leads families to the actions and decisions that ensure quality care and an optimal life for those they love, thus reducing worry, stress and time off of work for family caregivers through: Assessment and monitoring Planning and problem-solving Education and advocacy Family caregiver coaching This business is independently owned and operated. Your application will go directly to the business, and all hiring decisions will be made by the management. All inquiries about employment at this business should be made directly and not to Aging Life Care Association.

The Care Manager l - Waiver assures that individuals and families with special health care needs receive integrated whole-person-person centered care management, including coordinating across physical health, behavioral health, pharmacy and unmet health-related resource needs to ensure they are linked to services and supports in an effort to maximize potential outcomes and decrease the unnecessary use of hospitals and emergency services by assuring that appropriate quality care is in place. The Care Manager I focus on a specified population of members utilizing health care services while ensuring all member health needs and referrals are addressed. The Care Manager l will collaborate with other community systems to work in partnership to support the identified population. This position will require extensive travel and may include going into homes of members we serve. Responsibilities & Duties Complete Assessment/Planning Complete comprehensive assessments or Care Needs Screening at enrollment, yearly or at changes in condition Develop Plans of Care derived from the completed assessments Demonstrate commitment to whole person/integrated care Assign interventions/plans of care to applicable Alliance Care Management team member to meet identified member needs, for monitoring, and/or service engagement activities Complete required Screening Tools Retrieve and review historical data to better-understand member's treatment history Submit referrals to the Transition Coordinator when a physical health or behavioral health need indicates medical and/or pharmaceutical complexity Assign Plan of Care activities to Community Health Worker if member has identified Social Determinants of Health (SDOH), disparities and/or complex payer issues Assist individuals/legally responsible persons (LRP) in choosing service providers, ensuring objectivity in the process Consistently evaluate appropriateness of services and ensure implementation of plan of care through information gathering and assessment at defined frequency of contact based on risk stratification Utilize person centered planning, motivational interviewing and historical review of assessments in JIVA to gather information and to identify supports needed for the individual Assist in collecting data to be used to identify and address barriers as well as determine the effectiveness of care management/care coordination in reducing lengths of stay and use of emergency services Actively collaborates with members/legally responsible person, care team, service providers, and identified supports to ensure development of a plan that accurately reflects the individual's needs and desired life goals including collaborating with residential placement search in conjunction with internal team members or external stakeholders as needed Submits required documentation to UM to ensure timely delivery of services - and trouble shoot until authorization is obtained. Notify a member's care team and providers of successful authorization (for residential or waiver related services) For Medicaid C, enlist administrative support to send Level of Care (LOC) and initial Individual Service Plan (ISP) to Department of Social Services (DSS) to turn on special waiver program indicator. Verify that necessary Client, Employer, Group (CEG) enrollments are correct in JIVA, and that Medicaid eligibility is updated in Alliance Claims System Provide Support and Monitoring to Members Schedule initial contact with member for purpose of assessment and engagement Verify accuracy of demographic information with member. Update inaccurate information from the Global Eligibility File following documented protocols Schedule face to face, virtual, and telephonic meeting with member/guardian to provide education about Alliance Health Plan, care teams, resources, and services Provide education and support, to individuals and LRP, in learning about and exercising rights, explanation of the grievance and appeals process, available service options, providers available to meet their needs, and payer requirements that may impact service connection and maintenance Refer members who are in crisis/institutional setting and require assistance with returning to community based services to the Integrated Health Consultant or applicable care team member Recognize and report critical incidents and provider quality concerns to supervisors and Quality Management Department Complete activities in JIVA related to Plans of Care developed from the Care Management Comprehensive Assessment or other assessments as deemed necessary Coordinate with other team members to ensure smooth transition to appropriate level of care when needed Communicate with member to check on status, verify care needs are met and that no new clinical needs warrant a change in condition assessment Provide follow up coordination with key stakeholders to promote engagement Promote customer satisfaction through ongoing communication and timely follow-up on any concerns/issues Verify that ongoing service adherence is maintained through monitoring meetings with member and/or guardian or provider Identify barriers to treatment and assist individuals with arranging appointments or linking to treatment providers Maintain required contacts with member/legally responsible person per state contractual requirements meeting minimum expectations Attend community, provider, stakeholder meetings as needed for member and/or as directed to support the needs of the health plan Coordinate and participate with SIS Team to ensure successful completion of SIS assessment within time frames allotted For facility (ICF, Hospital, PRTF or SDC) discharges, inform SIS Supervisor that an assessment needs to be scheduled Schedule and facilitate the ISP meeting, develop and update ISP Submit requests for services and purchase orders for products, supplies, and services covered under the Innovations waiver Complete check-in/contact with member and/or legally responsible person (LRP) via phone or email Complete Home and Community Based Services (HCBS) Notice of Change Form when arranging new HCBS service placement (for Residential Supports, Day Supports, and Supported Employment) with a new provider and submit to Provider Network department to ensure successful transition to provider Review service utilization and documentation as required by the member's program enrollment to monitor progress toward individualized goals and fulfillment of the intent of the service authorized Proactively respond to an individual's planned movement outside the Alliance MCO geographic area to ensure a smooth transition without lapse in care Engage with Providers Engage with Providers to identify barriers to service delivery at the member level and work toward individualized resolution with both the member and provider Ensure assessments, person-centered plans, discharge plans, and crisis plans are completed and shared with providers with whom the individuals are linked Report changes in member's health status to authorized providers Service Monitoring For Medicaid C services: conduct in-person, field-based observation of the member's experience with service delivery per the frequency and requirements outlined in the Medicaid C waiver and Home and Community-based Services (HCBS) standards For Non-Medicaid C services: complete (a) Provider Engagement Tool to assess provider support needs (to engage member in services) and (b) interventions to resolve administrative barriers to care; Review service utilization and documentation as required by the member's program enrollment to monitor progress toward individualized goals and fulfillment of the intent of the service authorized Complete Documentation Obtain and upload all supporting documentation, Legally Responsible Person (LRP) verification, and release of information that will improve care management activity on behalf of the member Open new episodes in JIVA when needed and schedule initial contact with member to verify accuracy of demographic information and initiate the rapport building process Document all applicable member updates and activities per organizational procedure Escalate complex cases and cases of concern to immediate supervisor. Ensure that service orders/doctor's orders are obtained, as applicable Share appropriate documentation with all involved stakeholders as consent to release is granted Obtain releases/documentation and provide to all stakeholders involved Maintains medical record compliance/quality Proactively respond to an individual's planned movement outside the Alliance geographic area, or other transition need, to ensure a smooth transition without lapse in care Distribute surveys to members in service Ensure clinical documentation (e.g. goals, plans, progress notes, etc.) meets state, agency documentation standards, and Medicaid requirements Compliance with Alliance Policy and Procedure Adheres to all Alliance Organizational Policies and Procedures and Care Management Desk Procedures Travel Travel between Alliance offices, attending meetings on behalf of Alliance, participating in Alliance sponsored events, etc. may be required Travel to meet with members, providers, stakeholders, attend court hearings etc. is required Minimum Requirements Bachelor's degree from an accredited college or university in Human Services field and two (2) years of post-bachelor's degree mh/dd/sa experience with the population served. Experience must include two (2) years IDD, service delivery monitoring, and care management experience. Or Bachelor's degree from an accredited college or university in non-human Services field and four (4) years of post-bachelor's degree mh/dd/sa experience with the population served. Experience must include two (2) years IDD, service delivery monitoring, and care management experience. Or Master's Degree from an accredited college or university in Human Services field and one (1) year of post graduate degree mh/dd/sa experience with the population served. Experience must include two (2) years IDD, service delivery monitoring, and care management experience. Or Fully or Provisionally Licensed in the State of North Carolina as a LCSW, LCMHC, LPA, or LMFT and two (2) years IDD, service delivery monitoring, and care management experience. Or Licensed Registered Nurse (RN) in the State of North Carolina with four (4) years of mh/dd/sa experience with the population served. Experience must include two (2) years IDD, service delivery monitoring, and care management experience. Preferred: NACCM, NADD-Specialist and/or CBIS Certification Knowledge, Skills, & Abilities Person Centered Thinking/planning Knowledge of using assessments to develop plans of care Knowledge of LOC process, SIS for IDD and FASN assessment for TBI Knowledge of Medicaid basic, enhanced MHSUD, and waiver benefits plans Knowledge of and skilled in the use of Motivational Interviewing techniques Strong interpersonal and written/verbal communication skills Conflict management and resolution skills Proficient in Microsoft Office products (such as Word, Excel, Outlook, etc.) High level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance. Ability to make prompt, independent decisions based upon relevant facts 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: **************************** Salary Range $28.96 - $37.65/ Hourly 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 Disability Generous retirement savings plan Flexible work schedules including hybrid/remote options Paid time off including vacation, sick leave, holiday, management leave Dress flexibility

The Care Manager has overall day-to-day responsibility for coordinating the activities of the care team for clients with complex medical and/or psychiatric conditions and for facilitating clients' access to the full range of medical and psychosocial services efficiently and effectively. The Care Manager is mainly responsible for coordinating medical care by receiving inpatient and ER admissions of targeted clients. In addition, the Care Manager is responsible for visiting clients during inpatient stays and participating actively in discharge planning and care transition activities. The position currently follows a hybrid schedule. Essential Job Functions The following duties are mandatory requirements of the job: Complete intakes, assessments, reassessments, and develop care plans. Conduct home visits and community follow-ups to monitor services and the client's status. Participate in case conferences with other providers. Attend supervisory meetings. Maintain contact with the client's extended family and informal support networks. Escort clients to/from service provider appointments when necessary. Monitor the client's progress in utilizing services. Conduct care coordination with providers/family for written individualized care plans. Work closely with the interdisciplinary care team, including PCP, psychiatrist, therapist, residential services, and substance abuse treatment program. Review the client's intake assessment and use the identified needs to coordinate completing the care plan. In conjunction with the client, the Care Manager is responsible for identifying potential barriers to care and possible resolutions. Conduct outreach to clients via phone and home visits to review care plan goals. Evaluate medication compliance and assess potential barriers to adherence; ensure medication reconciliation is current. Contact clients on discharge from inpatient services and ER or within 24 hours and ensure any follow-up for transitional care. Outreach to clients to facilitate keeping scheduled appointments; arranges for metabolic and periodic preventive screening. Ensure that clients and caregivers know test results by facilitating a discussion between the client and physician as necessary. Coordinate services between the client and extended care team providers to ensure that the integrated care plan is fully implemented. Regularly reviews client information from care team members to identify clients requiring outreach and engagement. Provide or arrange self-management/ wellness education to peers and other support groups in the language the client/family prefers. Organize and participate in the case of conferences periodically, as necessary. Review benefits, entitlements, and housing with the client/family and assist in the application process. Follows up as required to ensure services are approved. Responsible for providing a successful/billable core service to all clients in your caseload. Assist in crisis intervention. OTHER RESPONSIBILITIES The following duties are to be performed as assigned by the supervisor: Participate in CQI activities. Participate in conferences, workshops, and other professional development activities to maintain licensure and remain professionally current with advances in the field of expertise. Participate in multidisciplinary task forces, committees, and projects. Perform other related duties to maintain your caseload in compliance with the Health Home lead's policy and procedures. Minimum qualifications Education: Associate's degree in Social Services with two to three years of relevant experience. Experience: Preferably 1-3 years of experience in healthcare, social work, case management, or discharge planning. Special skills and knowledge Excellent computer skills necessary. Able to use word processing, spreadsheet, and database programs as required by the position. Excellent oral and written communication skills. Excellent interpersonal skills. Good problem-solving, decision-making, and judgment skills. Must read, write, and speak English to the extent required by the position.

At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing clinical services you'll work alongside dedicated professionals who share your commitment to excellence and make a meaningful impact. Join us in fueling our mission to protect dreams and restore lives, while building your career in an environment that values collaboration, innovation, and personal growth. Be part of a team that makes a real difference. This is a full-time, work-from-home position. The candidate must be located in the Plant City, Florida area due to regular local travel for in-person patient appointments. Perks: Full and comprehensive benefits program, 24 days of paid vacation/holidays in your first year plus sick days, home office equipment including laptop and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers' compensation case management training. Join our compassionate team and help make a positive difference in an injured person's life. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning. In this role, you will: * Demonstrate knowledge, skills, and competency in the application of case management standards of practice. * Use advanced knowledge of types of injury, medications, comorbidities, treatment options, treatment alternatives, and knowledge of job duties to advise on a treatment plan. * Interview disabled persons to assess overall recovery, including whether injuries or conditions are occupational or non-occupational. * Collaborate with treating physicians/providers and utilize available resources to help create and implement treatment plans tailored to an individual patient. * Work with employers and physicians to modify job duties where practical to facilitate early return to work. * Evaluate and modify case goals based on injured/disabled person's improvement and treatment effectiveness. * Independently manage workload, including prioritizing cases and deciding how best to manage cases effectively. * Complete other duties, such as attend injured worker's appointments when appropriate, prepare status updates for submittal to customers, and other duties as assigned. Qualifications * Education: Associates Degree or Bachelor's Degree in Nursing or related field. * Experience: 2+ years clinical practice preferred. Workers' compensation-related experience preferred. * Skills: Ability to advocate recommendations effectively with physicians/providers, employers, and customers. Ability to work independently. Knowledge of basic computer skills including Excel, Word, and Outlook Email. Proficient grammar, sentence structure, and written communication skills. * Certifications, Licenses, Registrations: * Active Registered Nurse (RN) license required. Must be in good standing. * URAC-recognized certification in case management (CCM, CDMS, CRC, CRRN or COHN, COHN-S, RN-BC, ACM, CMAC, CMC). * Travel: Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography. * Internet: Must have reliable internet. * Transportation: Must have reliable transportation and be able to travel to and attend in-person appointments with injured workers in assigned geography. Benefits We're committed to supporting your ultimate well-being through our total compensation package offerings that support your health, wealth and self. These offerings include Medical, Dental, Vision, Health Savings Accounts / Flexible Spending Accounts, Life and AD&D Insurance, 401(k), Tuition Reimbursement, and an array of resources that encourage a lifetime of healthier living. Benefits eligibility may differ depending on full-time or part-time status. Compensation depends on the applicable US geographic market. The expected base pay for this position ranges from $63,000 - $85,000 annually. In addition to the base salary, you will be eligible to participate in our productivity-based bonus program. Your total compensation, including base pay and potential bonus, will be based on a number of factors including skills, experience, education, and performance metrics. The Company is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability. Don't meet every single requirement? Studies have shown that women and underrepresented minorities are less likely to apply to jobs unless they meet every single qualification. We are dedicated to building a diverse, inclusive, and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles. #LI-VH1 #FCM Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers' Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager

Omatochi is actively seeking a compassionate and detail-oriented Care Manager to join our team. In this non-medical role, you will play a crucial part in coordinating and overseeing support services for our clients. The Care Manager will work closely with various stakeholders to ensure our clients receive the assistance and resources needed to improve their quality of life. The ideal candidate for this position is empathetic, organized, and possesses excellent communication skills. Responsibilities: Client Assessment and Support Planning: Conduct thorough assessments of clients' needs, considering their personal, social, and emotional requirements. Develop tailored support plans in collaboration with clients, their families, and relevant agencies. Coordinate with community resources to provide clients with appropriate services and assistance. Care Coordination and Advocacy: Serve as the main point of contact for clients, connecting them with relevant services and programs. Advocate for clients' needs, ensuring they receive timely and adequate support from various organizations and service providers. Monitor the progress of support plans and adjust them as necessary to meet clients' changing requirements. Client and Family Education: Educate clients and their families about available support services, community resources, and self-help techniques. Provide guidance on effective coping strategies and assist in developing life skills. Address clients' concerns and queries, building a trusting and supportive relationship. Documentation and Reporting: Maintain accurate records of client assessments, support plans, and interactions. Generate detailed reports on client outcomes, program effectiveness, and areas for improvement. Ensure compliance with organizational protocols and reporting requirements. Collaboration and Professional Development: Collaborate closely with community organizations, social workers, and relevant agencies to enhance the overall quality of client support. Participate in regular team meetings, training sessions, and workshops to stay informed about the latest developments in social services and care management. Pursue continuous professional development, seeking opportunities to expand knowledge and skills in the field of care management. Qualifications: Valid Drivers License and Vehicle Bachelor's degree in Social Work, Psychology, Counseling, Human Services, or a related field. Proven experience in non-medical care management, case management, or social services. Strong understanding of social service regulations, policies, and procedures. Excellent interpersonal skills, including active listening and empathy. Ability to work independently, prioritize tasks, and manage time efficiently. Proficiency in using case management software and other relevant tools. Benefits: Competitive salary and performance-based incentives. Comprehensive benefits package, including health, dental, and vision insurance. Generous paid time off, including vacation, personal days, and holidays. Ongoing professional development opportunities. Region and Travel: This is a position with a strong field-based component. While the incumbent will have flexibility to work from home, they are expected to travel extensively-approximately 50% to 80% of the time-within Santa Cruz County. This role requires a high level of mobility and availability to attend in-person visits, community events, and other field-based responsibilities throughout the geographic area of responsibility. Mileage Reimbursement / Vehicle Allowance: Travel-related expenses are reimbursed and whether a monthly stipend is provided for vehicle use. Scheduling Flexibility: Incumbent has autonomy over scheduling and is responsible for balancing field and administrative work. Omatochi is committed to creating an inclusive and diverse work environment. We encourage applications from candidates of all backgrounds and experiences.

This position provides medical case management referral services, crisis intervention and eligibility determination services to adults with HIV infection receiving medical services in the outpatient Infectious Diseases Clinic. A very small percentage of time may include services to patients with other infectious diseases. The employee will complete assessments and identify service needs, facilitate linkage to services and coordinate with community agencies. They may assist with transportation and housing needs. Responsibilities may include assisting clients in accessing financial benefit programs. The employee will work closely with the existing licensed social work team, medical providers, nursing staff, and benefits coordinators as part of an interdisciplinary team. Requires timely data entry and data management in an electronic medical record ( EPIC ), electronic databases and tracking systems. Successful employees possess a strong ability to multi-task in a fast-paced environment. Employees are required to attend meetings as directed. Required Qualifications, Competencies, And Experience Bachelor's degree in a Human Service field with clinical experience. Preferred Qualifications, Competencies, And Experience Experience with clinic population, electronic medical records, and data management preferred. Course work in Social Work. Work Schedule Monday - Friday, 8:00 AM - 5:00 PM; fully remote position

Salvo is looking for an experienced Nurse to support our chronic disease patients. In this role, you'll be a key contributor to the management and delivery of our care program, working closely with our patients, registered dietitians, and partner physicians to provide best-in-class care. You'll use your medical knowledge and product expertise to help our members navigate Salvo Health, assisting in medical and administrative tasks to keep the member moving through the program. Additionally, you'll help shape how we build and scale our product and process. Our ideal candidate is someone who enjoys the challenges of an early-stage start up, is eager to learn, process oriented, and has a patient-first mindset. What You Will do: Provide exceptional care, disease management and health education to patients Support goal setting for individual patients asynchronously to help them better manage their chronic conditions Create personalized action plans with guidelines to reduce or eliminate unwanted behaviors Help clients understand their motivations and create behavior change plans Conduct regular outreach to patients, based on their needs and preferences, to support engagement and elicit behavior change Coordinate with other clinical team members to provide an exceptional patient experience Develop and maintain professional, support-oriented working relationships with patients and team members Create and distribute health education materials to individual members as necessary Work with a cross-functional product team to develop and constantly improve our in-app patient experience Qualifications: 2+ year of experience as Licensed Practical Nurse or any Nursing license 2+ years of experience in patient-facing or customer-facing roles Compact state license required, additional licensing may be needed Bilingual (spanish speaking) a plus Excellent customer relation skills, as well as written and verbal communication skills Knowledge of medical terminology and proficiency of general medical office procedures Familiarity with digital applications like Slack, Coda, Google Workspace, etc. Strong analytical and proactive problem solving skills Self-motivated, results-oriented and strategic thinker Personal passion for health and wellness topics Must be authorized to work in the United States Experience working in telehealth or healthcare startup environment preferred Bonus: Experience working in GI, weight management, and/or with anti-obesity medications such as GLP-1s Salvo is a new approach to help millions of Americans facing chronic health conditions, centered on chronic gut health and metabolic conditions from IBS to obesity. Our patients are assigned a “whole patient” care team and have seven day a week access to app-based care, using Remote Patient Monitoring (“RPM”) to bill under the patient's insurance. This is a major step forward to go beyond episodic appointments to continuous care at home, and deliver interdisciplinary wraparound care in partnership with the patient's existing local doctor. Salvo is backed by leading health care investors from innovators like Livongo, Ro, Ginger, Forward, Brightline, Tia, and others. Salvo care draws on expertise from Board-certified specialty physicians, registered dietitians, nurses, psychologists, and therapists who have developed our evidence-based protocols, for a personalized, multi-month journey to better health. Salvo is the first to bring a scalable and tech-enabled, more integrative approach to these chronic conditions, going beyond treating only the symptoms in order to identify and address the root causes of chronic illness. Salvo offers a competitive salary and health benefits, a remote work environment, flexible time-off, a larger sense of mission, and professional development and entrepreneurial opportunities. Working alongside a bunch of super talented and friendly people, in a culture that likes to drive constant innovation, and marked by relentless curiosity and a sense of empathy. Salvo is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Insight Global is hiring for a Remote Care Manager to support our micro clinic operations in Raleigh, NC. You will work in a virtual setting with providers, paramedics, and patients to partner in the care continuum process. You will lead the clinical onboarding of new contracts, handle referrals & authorizations, and ensure seamless communication with all stakeholders. Responsibilities will include: · Develop and monitor care plans in collaboration with multiple providers, adjusting as needed · Follow up on interventions to prevent unnecessary ER visits and hospital admissions · Serve as the primary liaison between patients, families, and healthcare staff to ensure seamless communication · Navigate multiple healthcare platforms including EHRs, payer portals, billing software, and patient messaging systems · Ensure timely and accurate documentation across systems to support care continuity and compliance · Verify provider participation, coverage, and pre-authorization requirements with insurance administrators and healthcare facilities · Optimize client contracts and referral workflows to enhance scalability and efficiency in care coordination · Schedule and manage appointments, follow-ups, and referrals to specialists and services · Educate patients on conditions, medications, and treatment plans to promote understanding and adherence · Track patient progress and address barriers to treatment plan compliance We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to ********************.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: **************************************************** Skills and Requirements · RN Licensure or Paramedic Licensure in North Carolina · Minimum of 3 years of experience in care coordination (care or case management) · Strong knowledge of insurance benefits, prior authorizations, and referral management · Proficiency with EMR/EHR systems, payer portals, and standard office software (60% of role) · Strong communicational & organizational skills - ability to work efficiently with a team

About the role The April Parker Foundation is seeking compassionate, detail-oriented Care Managers (Generalists) to deliver Enhanced Care Management (ECM) and Community Supports (CS) services to Medi-Cal members with complex medical, behavioral, and social needs. You'll work directly with individuals experiencing housing insecurity, chronic illness, or behavioral-health challenges helping them navigate care, access community resources, and achieve stability in health and housing. This is a field-based / remote role ideal for professionals who value flexibility and meaningful impact. What you'll do Conduct outreach, assessments, and individualized care plans for ECM and CS members. Coordinate medical, behavioral, and social-service supports-including housing navigation and tenancy services. Complete timely documentation and progress tracking in APF systems. Provide in-person, telephonic, and virtual encounters based on member needs. Collaborate with health plans, community partners, and APF multidisciplinary teams. Maintain strict confidentiality and compliance with Medi-Cal, DHCS, and ILS guidelines. Compensation Base Salary (Straight-Time Pay) Salary is based on your caseload and is calculated using a simple, transparent formula: Each member = 2 paid hours per member per month (PMPM), at $25.00/hour ($50 PMPM) Your monthly salary increases as your caseload increases. Incentive Pay (Additional Earnings) You earn $40 per member per month for delivery qualified, on top of your base salary. Bringing total compensation to $90 PMPM, equivalent to $45/hour Reimbursements & Stipends Mileage reimbursement at the IRS rate $50/month phone stipend Reimbursement for approved work-related expenses Schedule Work hours are flexible and self-directed, provided Care Managers meet service delivery requirements and member availability Qualifications Minimum 2 years of experience in case management, care coordination, or related field Knowledge of Medi-Cal CalAIM programs, community resources, and social determinants of health Excellent documentation, organization, and communication skills Valid California Driver's License, auto insurance, and reliable transportation Preferred: Bachelor's degree or CHW certification; CA licensure (LCSW, LMFT, LPCC, RN, etc.)

Who We Are Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs. We deliver 24/7 virtual first and in home medical, behavioral, and social care, working alongside families, providers, and health plans to break down barriers to quality care. We do not replace existing care teams; we enhance them, providing an extra layer of support with compassion, creativity, and an unwavering commitment to children with medical complexity. The primary location for this role is remote, and expected schedule requirements are Monday to Friday, 8:00am - 5:00pm and 10:30am - 07:00 pm Eastern time. What You'll Do As a Neurodevelopmental Care Manager with Imagine Pediatrics, you will provide compassionate care to families and children with neurodevelopmental needs, providing care management services. In this position, you will leverage an integrated technology platform and are complimented by an internal interdisciplinary care team. Your primary responsibilities will include: This role requires delivery of patient care to with children and families experiencing neurodevelopmental diagnoses including but not limited to: Autism Spectrum Disorder, Attention Deficient Hyperactivity Disorder, and Intellectual & Developmental Disabilities. Conduct comprehensive biopsychosocial assessments to evaluate the strengths, challenges, and needs of children and families. Formulate care plans that are consistent with patient diagnoses, non-medical drivers of health, and caregiver education & support. Continuously evaluate the effectiveness of care plans including identifying the need for further services including ABA, speech therapy, occupational therapy, physical therapy, psychiatry, and more. Provide ongoing case management and adjust interventions and/or care plans based on patient and family progress. Provides family support and education on the nature of neurodevelopmental diagnosis and progression, the importance of treatment adherence, and related information as appropriate Advocate for clients in IEP/504 planning, disability services, and other supportive programs. Identify and coordinate resource referrals for external support and allied services. Collaborate with other professionals in the patient's care team including schools, therapists, health care providers, and more for a holistic approach. Respond to crisis to de-escalate and stabilize patient and family members. Maintain accurate and timely documentation in accordance with company policies and procedures. Performs other duties and assumes other responsibilities as assigned by manager What You Bring & How You Qualify First and foremost, you're passionate and committed to creating the world our sickest children deserve. You want an active role in building a diverse and values-driven culture. Things change quickly in a startup environment; you accept that and are willing to pivot quickly on priorities. In this role, you will need: Masters' degree with major course work in social work or related field (MSW or LMSW prefered). Minimum 3-5 years of post-graduate experience in health care social work/Case management. Experience working with pediatric population and family systems required Experience working in settings such as ABA centers, school systems, or specialized neurodevelopmental programs preferred Strong knowledge of neurodevelopmental diagnoses and systems involved in patient's care (schools, ABA, ST/PT/OT). Strong knowledge of IDEA, ADA, Medicaid, and social services systems Additional certifications/training regarding neurodevelopmental diagnoses is preferred. Bilingual Spanish required Role is remote with 10% travel necessary for training/education purposes Ability to work afternoons and evenings What We Offer (Benefits + Perks) The role offers a base salary range of $70,000 - $77,000 in addition to annual bonus incentive, competitive company benefits package and eligibility to participate in an employee equity purchase program (as applicable). When determining compensation, we analyze and carefully consider several factors including job-related knowledge, skills and experience. These considerations may cause your compensation to vary. We provide these additional benefits and perks: Competitive medical, dental, and vision insurance Healthcare and Dependent Care FSA; Company-funded HSA 401(k) with 4% match, vested 100% from day one Employer-paid short and long-term disability Life insurance at 1x annual salary 20 days PTO + 10 Company Holidays & 2 Floating Holidays Paid new parent leave Additional benefits to be detailed in offer What We Live By We're guided by our five core values: Our Values: Children First. We put the best interests of children above all. We know that the right decision is always the one that creates more safe days at home for the children we serve today and in the future. Earn Trust. We listen first, speak second. We build lasting relationships by creating shared understanding and consistently following through on our commitments. Innovate Today. We believe that small improvements lead to big impact. We stay curious by asking questions and leveraging new ideas to learn and scale. Embrace Humanity. We lead with empathy and authenticity, presuming competence and good intentions. When we stumble, we use the opportunity to grow and understand how we can improve. One Team, Diverse Perspectives. We actively seek a range of viewpoints to achieve better outcomes. Even when we see things differently, we stay aligned on our shared mission and support one another to move forward - together. We Value Diversity, Equity, Inclusion and Belonging We believe that creating a world where every child with complex medical conditions gets the care and support, they deserve requires a diverse team with diverse perspectives. We're proud to be an equal opportunity employer. People seeking employment at Imagine Pediatrics are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information, or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

The Manager, Patient Ambassador Experience, will help develop and manage Inizio Evoke's growing Patient Ambassador program. This role will serve as a primary point of contact for everyday patients living with chronic conditions-helping them share their stories, guiding them through ambassador engagements, and ensuring a supportive, seamless experience when participating in client-sponsored initiatives. We are looking for a highly emotionally intelligent professional with experience in client service, partner management, logistics, and people-focused coordination. The Manager will be the “face and heart” of the organization to patient ambassadors and a trusted advisor to internal teams and clients. Responsibilities Support the strategy, structure, and execution of the Patient Ambassador program across multiple therapeutic areas (diabetes, inflammatory conditions, mental health, rare disease, etc.). Develop trusted, empathetic relationships with patient ambassadors; provide ongoing guidance, emotional support, and clear communication. Be the primary liaison between ambassadors, internal teams, and pharma clients-ensuring agreement on expectations, deliverables, compliance requirements, and project timelines. Oversee logistics for all patient engagements, including event preparation, travel arrangements, documentation, honoraria, and ambassador readiness. Develop processes, tools, and protocols that ensure a consistent, positive ambassador experience. Partner with internal compliance teams to ensure all interactions meet industry, legal, and ethical standards. Identify, recruit, and onboard new patient ambassadors to support expanding client needs. Manage and mentor coordinator-level support staff; manage workload, quality, and professional development. Track ambassador participation, program performance, and budget adherence; provide client reporting and insights. Qualifications 4-6 years of relevant experience in patient engagement, customer service, advocacy, client services, logistics, event planning, or administrative program management. Demonstrated ability to cultivate relationships with vulnerable or high-needs populations. Exceptional emotional intelligence, listening skills, and interpersonal communication. Strong organizational and project-management skills; experience managing multiple priorities simultaneously. Comfort navigating sensitive health-related discussions with professionalism and empathy. Experience working with or supporting healthcare, nonprofit, or advocacy organizations is a plus. Ability to travel as needed for events and ambassador support. Inizio Evoke offers a fully remote work environment and outstanding company-paid benefits, including medical, dental, 401(k), tuition reimbursement, and flexible time off. The base salary range represents the low and high end of the salary range for this position. This range may differ based on your experience and skill set, geographic location, and cost of living considerations. We consider compensation more than just a base salary - that's why we also offer an exceptional range of flexible benefits, personal support and tailored learning and development opportunities all designed to help you realize your full potential both in life and at work.Compensation$65,000-$85,000 USD Don't meet every job requirement? That's okay! Our company is dedicated to building a diverse, inclusive, and authentic workplace. If you're excited about this role, but your experience doesn't perfectly fit every qualification, we encourage you to apply anyway. You may be just the right person for this role or others.

The Care Manager's role is to work in partnership with individuals with I/DD, their family/guardian, and providers to coordinate care and services needed to assist individuals achieve optimal health, wellness, independence, community integration and accomplishing goals. The Care Manager is responsible for providing Health Home core services including comprehensive care management, care coordination and health promotion, comprehensive transitional care, individual and family support, referral to community and social support services, and use of Health Information Technology to link services. Care Managers will provide all services with a person-centered approach. Essential Job Functions: Conduct comprehensive assessments to identify an individual's clinical and psychosocial needs, choices, and preferences for services Assess and address health and safety issues as well as barriers to care and treatment including social determinants of health Collaborate with interdisciplinary team and incorporate input into comprehensive assessment and the person's Life Plan Facilitate, develop, and maintain a person-centered Life Plan that integrates an individual's personal wants and needs, clinical and non-clinical healthcare related needs, community services, OPWDD services, and natural supports. Incorporate health promotion and support opportunities for individuals to achieve and maintain optimal health and wellbeing Adhere to Incident Management regulations, guidelines, and policies and procedures Coordinate and ensure access to chronic disease management Facilitate referrals to clinical and community resources, including planning, implementation, and follow-up for comprehensive care management and transitional care Participate in internal and external audits Coordinate and provide access to long-term care supports and services Engage families and natural supports in the care coordination process Provide all individuals and families with services that are culturally and linguistically appropriate Advocate on behalf of the individual Promote self-advocacy and the ability to self-direct Use Health Information Technology for documentation, to link services, and facilitate communication among care coordination team Secure all health records and other protected information with the highest regard to confidentiality and HIPAA laws and regulations Maintain compliance with all state and federal laws and regulations, Medicaid compliance, and PCC policies and procedures Document all services and maintain appropriate records following all established documentation policies and procedures Complete all required training including annual, ongoing, and educational trainings Perform all other duties relevant to the position as requested. Knowledge, Skills, and Abilities Ability to act quickly, assess and act accordingly in crisis situations Intermediate technology skills in Outlook, Teams, Word, Excel, online applications as needed Understanding use of an EHR system Knowledge of ethical and professional responsibilities and boundaries Demonstrate professional work habits including dependability, time management, organization, autonomy, and productivity Some positions may require bi-lingual skills Education and Experience: Bachelor's degree with two years of relevant experience OR A license as a Registered Nurse with two years of relevant experience, which can include any employment experience and is not limited to case management/service coordination duties OR A Master's degree with one year of relevant experience. Physical Requirements/Working Conditions: Ability to sit/stand throughout day to accomplish job Ability to enter data, notes, and other documentation into a computer. Must be able to travel throughout covered territories in Upstate NY as needed. Must have a valid driver's license Ability to conduct in-person visits and meetings at individuals homes, communities, schools, and other locations as applicable Ability to work remotely, satellite office locations, and/or primary office location Corporate Qualifications/Expectations: Adhere to all Prime Care Coordination policies and procedures. Adhere to the Agency Mission, Vision, Shared Values, and Customer Service Standards. Attend mandatory education and training modules as scheduled; obtain and maintain required certifications. Maintain all required certifications/training by State regulations and PCC policy Act as a professional representative of PCC in regard to appearance, behavior, temperament, communication, language, and dress.

The Patient Access Manager (PAM) II-Adherence Specialist is a non-sales regional, field-based position that will work directly with patients, families, and their provider(s) to address barriers, through information and education, to patient starting on therapy and staying on therapy, if appropriate. This role demonstrates superior customer facing skills working directly with multiple external and internal stakeholders including patients, prescribers, and advocacy groups. The PAM II is a subject matter expert in navigating insurance coverage and assisting in securing reimbursement through prior authorizations and appeals. The PAM II will also provide patient education, disease state and product education as well as general support for the patients and their caregivers. This role will appropriately interact and engage internal and external with teams but will serve as the point person responsible for identifying and resolving issues impacting treatment initiation and ongoing therapy. This position will also serve as the primary source for all regional patient advocacy activities. The PAM II will leverage his/her overall business acumen, therapeutic area knowledge, and patient access expertise to provide developmental guidance to their Patient Access Manager I colleagues. Location: Nationwide Remote Responsibilities Upon confirming a valid consent, meet and work closely with patients/families to work through the steps required to gain access to therapy (insurance navigation, understanding of payer policy and procedure for prior authorization, denial appeals, disease and product education, site of care logistics, and other support services). Provide education and information through the prior authorization/appeal processes and coordinate the delivery of appropriate documentation to achieve and maintain coverage. Complete a comprehensive assessment of the individual needs of the patient. This assessment will include understanding the individual's payer policies, plan designs, including Medicaid coverage if applicable, as well as the healthcare system local to the patient. Develop and offer solutions to the family, when necessary, that may also include communication of alternative insurance options and how families can best connect to available resources including charitable organizations such as PAF and NORD. Appropriately interact with and engage internal teams including commercial and medical and external teams including patients and/or their caregivers; payers; specialty pharmacy, physician offices, charitable organizations and patient advocacy organizations; Serve as the point person responsible for identifying and resolving issues impacting treatment initiation and ongoing therapy Provide support for the caregivers and collaborate with them in a way that allows for forward progress. Be knowledgeable of any changes in the payer access environment to identify issues that may impact access and communicate information appropriately to colleagues. Facilitate rare disease network/relationships through local advocacy groups, rare disease related events, and attending national conferences. Support organizing and participating in patient-to-patient meetings and programs. Maintains up-to-date knowledge on product resources available to support patients/caregivers at the regional level and applies this knowledge in a way that supports patient care. Offers subject matter expertise on trends, compliance, and other disciplines that impact the Patient Access role to help elevate the overall performance of the Patient Access team. May support the Manager, Patient Access Readiness, in identifying and implementing strategies and programs that help the PAM team be maximally effective in their roles. Coaches and mentors new members of the team. Qualifications BS/BA or relevant four-year degree. Advanced degree preferred. Minimum of 5 years' total business experience in the healthcare or biotech industry with at least 3 years' field-based experience in account management, sales, or field reimbursement. Experience working directly with patients and caregivers and in rare disease experience a plus. A deep understanding of insurance products and medication reimbursement process with a successful track record in field reimbursement, clinical education or in pharmaceutical sales/management of products that required significant payer and reimbursement involvement Seasoned, mature pharmaceutical/biotech professional with a comprehensive understanding of field / patient reimbursement, charitable funding, non-profit organizations Experience leading cross functionally and influencing without authority Case management experience in rare disease a plus including experience dedicated to assisting patients/caregivers Must be familiar with relevant legal and regulatory environment in biotech industry such as the Food Drug and Cosmetic Act, Anti-Kickback Stature, HIPAA and other patient privacy guidance and regulations. Competencies: Written and Verbal Communications, Problem Solving, Presentation skills, Teamwork & Collaboration, Customer Service focus, Teamwork & Collaboration, Adaptability, Professionalism Working Conditions: Position may require periodic evening and weekend work, as necessary to fulfill obligations. Periodic overnight travel. Ability to Travel up to 10%. #LI-REMOTE As an equal employment opportunity and affirmative action employer, Xeris Pharmaceuticals, Inc. does not discriminate on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, veteran status, genetics or any other characteristic protected by law. It is our intention that all qualified applications are given equal opportunity and that selection decisions be based on job-related factors. The anticipated base salary range for this position is $100,000 - $180,000. Final determination of base salary offered will depend on several factors relevant to the position, including but not limited to candidate skills, experience, education, market location, and business need. This role will include eligibility for bonus and equity. The total compensation package will also include additional elements such as multiple paid time off benefits, various health insurance options, retirement benefits and more. Details about these and other offerings will be provided at the time a conditional offer of employment is made. Candidates are always welcome to inquire about our compensation and benefits package during the interview process. NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization.

Hello, how are you? Are you a LPN that is looking to improve the health of patients that have complex conditions? Do you live within a reasonable driving distance to St. Joseph, MO? Would you like to work from home and travel for the training/occasional meetings? If you answered yes to the above and have/are: Savvy with basic software/services such as email, word, excel, etc. Detail oriented to the point of annoying people because you pick up on things that others don't. Partial to helping people that are unappreciated, overlooked, and may not have any other types of support. A solid home/office environment that enables you to get the job done correctly whenever it needs to be done. Naturally competitive and want to win. YOU want to be the best and enjoy working with others who are the same. An active LPN license that is in good standing. ****1000 imaginary bonus points if you have long-term care, skilled nursing, assisted living, care management, or other experience working with patients who have chronic conditions.**** At SparroWell, we want to win by helping others get the best care possible. Our awesome team works with physicians, nurse practitioners, and other clinical team members that specialize in taking care of people with chronic illnesses. Our advanced care team also supports patients, families, as well as their caregivers to provide additional resources whenever needed. On any given day, our team is coordinating care, reviewing medications, auditing charts like a BOSS, collaborating with medical providers, and ultimately making a difference in the lives of patients we serve. We work from home but do occasionally meet in person for meetings and training on the latest requirements/guidelines. Go ahead, start the conversation by sending us your resume today. We will consider all applicants even though we prefer to work with nurses that have long-term care or post-acute experience. If you would like to learn more about our company, please visit us at **************************** Thank you for reviewing our opportunity and we look forward to hearing from you.

We are a rapidly growing healthcare organization dedicated to supporting patients living with chronic conditions. Our mission is to deliver personalized, high-quality care that empowers individuals to take control of their health with confidence. Through a fully remote model, our Care Managers guide patients through their care journeys-educating, advocating, and coordinating support that leads to better outcomes and smoother day-to-day management. We're looking for a motivated Care Manager who is eager to apply their medical knowledge in a hands-on, patient-facing role. This position is ideal for someone with a healthcare diploma, training, or any form of medical education or clinical exposure who wants to put that foundation to meaningful use. You'll act as the central point of contact for patients, helping them understand their conditions, navigate care plans, and stay on track with treatment while working alongside providers, social workers, and community partners. Key Responsibilities: Monitor and coordinate care plans by tracking progress, adjusting interventions, and maintaining consistent patient support. Provide clear, accessible education about chronic conditions, treatment options, and lifestyle strategies. Coordinate appointments, follow-ups, and referrals, ensuring smooth connection to appropriate providers. Maintain accurate patient records, including health information, insurance details, and supporting documentation. Respond promptly and empathetically to patient questions, concerns, and urgent needs. Partner with care teams to develop, assess, and refine patient-centered interventions. Collaborate with behavioral health, disease management, home health, social work, and community organizations for holistic care. Ideal Qualities and Skills: Strong verbal and written communication skills and the ability to simplify medical information for patients. Fluency in Spanish (spoken and written), with the ability to support Spanish-speaking patients and families. Solid problem-solving instincts and a proactive approach to anticipating patient needs. Organized, detail-oriented, and reliable in managing patient caseloads and documentation. Comfortable prioritizing tasks and managing time effectively in a remote environment. Collaborative mindset with genuine care for patient well-being. Healthcare diploma or equivalent preferred. Any level of medical or healthcare experience-clinical rotations, internships, coursework, or similar-is welcomed. Compensation: Competitive hourly rate of $15-$20 per hour, based on experience and qualifications (Full Time). A supportive remote environment with opportunities for professional growth and development. Fully Remote opportunity.

**This is a mobile position which will work primarily out in the assigned communities.** Competitive Compensation & Benefits Package! eligible for - Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and sick time accrual 12 paid holidays State Retirement (pension plan) 401(k) Plan with employer match Company paid life and disability insurance Wellness Programs Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Mobile/Remote position; Available for any of Partners' NC locations Projected Hiring Range : Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Mental Health Substance Use Care Manager focuses on working closely with community hospitals, providers, and stakeholders to engage adults and/or children/adolescents in mental health/substance use services. This position is responsible for providing proactive intervention and care management (treatment planning, assessment, referral/linkage, and monitoring) to ensure that members and recipients receive appropriate assessment, oversight and services. This is a mobile position with work done in a variety of locations. Role and Responsibilities: Provide education, referrals, care management activities surrounding available services and supports including Physical Health, Behavioral Health, I/DD, LTSS, TBI, Pharmacy, Vision, and Dental services/supports. Link to needed behavioral health and physical health care services and facilitating appropriate connections to primary healthcare services through Community Care of North Carolina, the Health Department, or other community health resources Coordinating and linking members to benefits Complete initial and yearly Care Management Comprehensive Assessment and Care Plan Conduct Care Team meetings and ensure treatment team members participate in treatment team meetings to address the needs of the member Conduct continuous monitoring of progress towards goals identified in Care Plan through in-person and collateral contacts with the member and member's supports, including family, information and formal caregivers and routine care team reviews Identify the gaps in needed services and intervene as needed to ensure the member receives appropriate care Identify and refer member to community resources Oversee care transitions for members who are moving from one clinical setting to another Maintain accurate tracking and data information for care management activities and outcomes including tracking of individuals in and out of services, those who are on waiting lists, those who need follow-up, and those on outpatient commitments Collaboration Serves as a collaborative partner in identifying system barriers through work with community stakeholders Manages and facilitates Child/Adult High Risk Team meetings in collaboration with DSS, DJJ, school systems, CCNC Care Managers, and other community stakeholders as appropriate The MHSU Care Manager may work with members in the communities Works in partnership with other LME/MCO departments to address identified needs within the catchment area Knowledge, Skills and Abilities: Extensive understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) Considerable knowledge of the MHSU/IDD service array provided through the network of the LME/MCO's providers Knowledge of LME/MCO's implementation of the 1915(b/c) waivers and accreditation Highly skilled at assuring that both long and short-range goals and needs of the individual are addressed and updated, while assuring through monitoring activities that service implementation occurs appropriately Exceptional interpersonal and communication skills Excellent computer skills including proficiency in Microsoft Office products (Word, Excel, Outlook, and PowerPoint) Excellent problem solving, negotiation, arbitration, and conflict resolution skills Detail-oriented, able to organize multiple tasks and priorities and effectively manage projects from start to finish Ability to make prompt independent decisions based upon relevant facts, to establish rapport and maintain effective working relationships Ability to change the focus of his/her activities to meet changing priorities A high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance Education/Experience Required: *Qualified Professional Care Manager: Bachelor's degree in a human service field and at least two years of full-time experience with the population served -or- Bachelor's degree in a field other than human services with at least four years of full-time experience with the population served -or- Master's degree in a human service field and one year of full-time experience with the population served *Provisionally Licensed Care Manager: Master's degree in a human service field and one year of full-time experience with the population served Current unrestricted LCSW-A, LCMHC-A, LCAS-A, LMFT-A Employee is responsible for complying with respective licensure board's continuing education/training requirements in order to maintain an active provisional license (prior to obtaining full licensure). *Licensed Care Manager: Master's degree in a human service field and one year of full-time experience with the population served -or- Licensure as a registered nurse (RN) and four (4) years of full-time accumulated experience with the population served Current unrestricted LCSW, LCMHC, LPA, LMFT, LCAS, or RN licensure with the appropriate professional board of licensure in the state of North Carolina. Employee is responsible for complying with respective licensure board's continuing education/training requirements in order to maintain an active license. Other requirements: Must reside in North Carolina. Must have ability to travel as needed to perform the job duties Education/Experience Preferred: Above requirements Licensure/Certification Requirements: Above requirements

This position consists of weekly in-person Care Management visits with the client, coordination with PCP and telephonic contact to ensure adherence to treatment plan. Also must be available to answer questions that the client may have between visits. During the visit CM will gather information and educate the patient on his or her disease management, medication administration, and home safety in order to the client remain safely at home. CM will assist patient and/or family member to connect with other needed resources such as meals, transportation to PCP, and insuring that all prescribed medications are in the home. At all times the Director of Healthcare Operations is available as a resource to CM. Requirements Must have at least 1 year verifiable experience as a RN, LPN or Social Worker Must have an active professional license in your state. Must have a good driving record, auto insurance, a reliable vehicle Must have internet access for visit and assessment logging Must be a dependable person The applicant must not have Disciplinary Actions against their professional license or be listed in the List of Excluded Individuals/Entities Search Responsibilities The RN, LPN or Social Worker will also be required to enter all assessment and visit information into the online system within 24 hours of the visit. Upon hire and prior to the first visit, a short online training session and webinar will need to be completed. You will be required to visit the client once a week, 4 times a month on going. Flexible schedule. Work from home.

LOCATION: Remote - must live in or near McDowell County, North Carolina. The person in this position must maintain residency in North Carolina or within 40 miles of the North Carolina border. This position requires travel. GENERAL STATEMENT OF JOB The Care Manager is responsible for providing proactive intervention and coordination of care to eligible Vaya Health members and recipients (“members”) to ensure that these individuals receive appropriate assessment and services. The Care Manager works with the member and care team to alleviate inappropriate levels of care or care gaps through assessment, multidisciplinary team care planning, linkage and/or coordination of services needed by the member across the MH, SU, intellectual/ developmental disability (“I/DD”), traumatic brain injury (“TBI”) physical health, pharmacy, long-term services and supports (“LTSS”) and unmet health-related resource needs networks. Care Managers support and may provide transition planning assistance to state, and community hospitals and residential facilities and track individuals discharged from facility settings to ensure they follow up with aftercare services and receive needed assistance to prevent further hospitalization. This is a mobile position with work done in a variety of locations, including members' home communities. The Care Manager also works with other Vaya staff, members, relatives, caregivers/ natural supports, providers, and community stakeholders. As further described below, essential job functions of the Care Manager include, but may not be limited to: Utilization of and proficiency with Vaya's Care Management software platform/ administrative health record (“AHR”) Outreach and engagement Compliance with HIPAA requirements, including Authorization for Release of Information (“ROI”) practices Performing Health Risk Assessments (HRA): a comprehensive bio-psycho-social assessment addressing social determinants of health, mental health history and needs, physical health history and needs, activities of daily living, access to resources, and other areas to ensure a whole person approach to care Adherence to Medication List and Continuity of Care processes Participation in interdisciplinary care team meetings, comprehensive care planning, and ongoing care management Transitional Care Management Diversion from institutional placement This position is required to meet NC Residency requirements as defined by the NC Department of Health and Human Services (“NCDHHS” or “Department”). This position is required to live in or near the counties served to effectively deliver in-person contacts with members and their care teams. ESSENTIAL JOB FUNCTIONS Assessment, Care Planning, and Interdisciplinary Care Team: Ensures identification, assessment, and appropriate person-centered care planning for members. Links members with appropriate and necessary formal/ informal services and supports across all health domains (i.e., medical, and behavioral health home) Meets with members to conduct the HRA and gather information on their overall health, including behavioral health, developmental, medical, and social needs. Administer the PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other screenings within their scope based on member's needs. The Care Manager uses these screenings to provide specific education and self-management strategies as well as linkage to appropriate therapeutic supports. The assessment process includes reviewing and transcribing member's current medication and entering information into Vaya's Care Management platform, which triggers the creation of a multisource medication list that is shared back with prescribers to promote integrated care. Supports the care team in development of a person-centered care plan (“Care Plan”) to help define what is important to members for their health and prioritize goals that help them live the life they want in the community of their choice. Ensure the Care Plan includes specific services to address mental health, substance use, medical and social needs as well as personal goals Ensure the Care Plan includes all elements required by NCDHHS Use information collected in the assessment process to learn about member's needs and assist in care planning Ensure members of the care team are involved in the assessment as indicated by the member/LRP and that other available clinical information is reviewed and incorporated into the assessment as necessary Work with members to identify barriers and help resolve dissatisfaction with services or community-based interventions Reviews clinical assessments conducted by providers and partners with Care Manager - LP and Care Manager Embedded - LP for clinical consultation as needed to ensure all areas of the member's needs are addressed. Help members refine and formulate treatment goals, identifying interventions, measurements, and barriers to the goals Ensures that member/legally responsible person (“LRP”) is/are informed of available services, referral processes (e.g., requirements for specific service), etc. Provides information to member/LRP regarding their choice of service providers, ensuring objectivity in the process Works in an integrated care team including, but not limited to, an RN (Registered Nurse) and pharmacist along with the member to address needs and goals in the most effective way ensuring that member/LRP have the opportunity to decide who they want involved Supports and may facilitate care team meetings where member Care Plan is discussed and reviewed Solicits input from the care team and monitor progress Ensures that the assessment, Care Plan, and other relevant information is provided to the care team Reviews assessments conducted by providers and consults with clinical staff as needed to ensure all areas of the member's needs are addressed Updates Care Plans and Care Management assessment at a minimum of annually or when there is a significant life change for the member Supports and assists with education and referral to prevention and population health management programs. Works with the member/LRP and care team to ensure the development of a Care Management Crisis Plan for the member that is tailored to their needs and desires, which is separate and complementary to the behavioral health provider's crisis plan. Provides crisis intervention, coordination, and care management if needed while with members in the community. Supports Transitional Care Management responsibilities for members transitioning between levels of care Coordinates Diversion efforts for members at risk of requiring care in an institutional setting Consults with care management licensed professionals, care management supervisors, and other colleagues as needed to support effective and appropriate member care. Collaboration, Coordination, Documentation: Serves as a collaborative partner in identifying system barriers through work with community stakeholders. Manages and facilitates Child/Adult High-Risk Team meetings in collaboration with DSS, DJJ, CCNC, school systems, and other community stakeholders as appropriate. Works in partnership with other Vaya departments to identify and address gaps in services/ access to care within Vaya's catchment. Participates in cross-functional clinical and non-clinical meetings and other projects as needed/ requested to support the department and organization. Participates in routine multidisciplinary huddles including RN, Pharmacist, M.D. to present complex clinical case presentation and needs, providing support to other CMs (Care Manager) and receiving support and feedback regarding CM interventions for clients' medical, behavioral health, intellectual /developmental disability, medication, and other needs. Works with Care Manager - LP and Care Manager Embedded - LP in participating in other high risk multidisciplinary complex case staffing as needed to include Vaya CMO/ Deputy CMO, Utilization Management, Provider Network, and Care Management leadership to address barriers, identify need for specialized services to meet client needs within or outside the current behavioral health system. Monitors provision of services to informally measure quality of care delivered by providers and identify potential non-compliance with standards. Ensures 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. Supports problem-solving and goal-oriented partnership with member/LRP, providers, and other stakeholders. Promotes member satisfaction through ongoing communication and timely follow-up on any concerns/issues. Supports and assists members/families on services and resources by using educational opportunities to present information. Verifies member's continuing eligibility for Medicaid, and proactively responds to a member's planned movement outside Vaya's catchment area to ensure changes in their Medicaid county of eligibility are addressed prior to any loss of service. Proactively and timely creates and monitors documentation within the AHR to ensure completeness, accuracy and follow through on care management tasks. Maintains electronic AHR compliance and quality according to Vaya policy. Works with Care Manager - LP and Care Manager Embedded - LP to ensure all clinical and non-clinical documentation (e.g. goals, plans, progress notes, etc.) meet all applicable federal, state, and Vaya requirements, including requirements within Vaya's contracts with NCDHHS. Participates in all required Vaya/ Care Management trainings and maintains all required training proficiencies. Other duties as assigned. KNOWLEDGE, SKILLS, & ABILITIES Ability to express ideas clearly/concisely and communicate in a highly effective manner Ability to drive and sit for extended periods of time (including in rural areas) Effective interpersonal skills and ability to represent Vaya in a professional manner Ability to initiate and build relationships with people in an open, friendly, and accepting manner Attention to detail and satisfactory organizational skills Ability to make prompt independent decisions based upon relevant facts. Well-developed capabilities in problem solving, negotiation, arbitration, and conflict resolution, including a high level of diplomacy and discretion to effectively negotiate and resolve issues with minimal assistance. A result and success-oriented mentality, conveying a sense of urgency and driving issues to closure Comfort with adapting and adjusting to multiple demands, shifting priorities, ambiguity, and rapid change Thorough knowledge of standard office practices, procedures, equipment, and techniques and intermediate to advanced proficiency in Microsoft office products (Word, Excel, Power Point, Outlook, Teams, etc.), and Vaya systems, to include the care management platform, data analysis, and secondary research Understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) within their scope and have considerable knowledge of 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 are preferred. Ability to complete and maintain all trainings and proficiencies required by Vaya, however delivered, including but not limited to the following: BH I/DD Tailored Plan eligibility and services Whole-person health and unmet resource needs (ACEs, trauma-informed care, cultural humility) Community integration (independent living skills; transition and diversion, supportive housing, employment, etc.) Components of Health Home Care Management (Health Home overview, working in a multidisciplinary care team, etc.) Health promotion (common physical comorbidities, self-management, use of IT, care planning, ongoing coordination) Other care management skills (transitional care management, motivational interviewing, person-centered needs assessment and care planning, etc.) Serving members with I/DD or TBI (understanding various I/DD and TBI diagnoses, HCBS, Accessing assistive technologies, etc.) Serving children (child-and family-centered teams, Understanding the “System of Care” approach) Serving pregnant and postpartum women with SUD or with SUD history Serving members with LTSS needs (Coordinating with supported employment resources Job functions with higher consequences of error may be identified, and proficiency demonstrated and measured through job simulation exercises administered by the supervisor where a minimum threshold is required of the position. EDUCATION & EXPERIENCE REQUIREMENTS Bachelor's degree required, preferably in a field related to health, psychology, sociology, social work, nursing or another relevant human services area. Serving members with BH conditions: Two (2) years of experience working directly with individuals with BH conditions Serving members with LTSS needs Two (2) years of prior Long-term Services and Supports (LTSS) and/or Home Community Based Services (HCBS) coordination, care delivery monitoring and care management experience. This experience may be concurrent with the two years of experience working directly with individuals with BH conditions, an I/DD, or a TBI, described above --If graduate of a college or university with a Bachelor's degree in Human Services, then incumbent must have two years of full-time accumulated experience in mental health with population served. --If graduate of a college or university with a Bachelor's degree is in field other than Human Services, then incumbent must have four years of full-time accumulated experience in mental health with population served. --If a graduate of a college or university with a Bachelor's Degree in Nursing and licensed as RN, then incumbent must have four years of full-time accumulated experience in mental health with population served. Experience can be before or after obtaining RN licensure. --If graduate of a college or university with a Master's level degree in Human Services, although only one year of experience is needed to reach QP status, the incumbent must still have at least two years of full-time accumulated experience in mental health with the population served *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. Preferred work experience: Experience working directly with individuals with I/DD or TBI PHYSICAL REQUIREMENTS Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading. Physical activity in this position 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. Ability to drive and sit for extended periods of time (including in rural areas) RESIDENCY REQUIREMENT: The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border. SALARY: Depending on qualifications & experience of candidate. This position is non-exempt and is eligible for overtime compensation. DEADLINE FOR APPLICATION: Open Until Filled APPLY: Vaya Health accepts online applications in our Career Center, please visit ****************************************** Vaya Health is an equal opportunity employer.