Geriatric care manager work from home jobs - 156 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.

Crinetics is a pharmaceutical company based in San Diego, California, developing much-needed therapies for people with endocrine diseases and endocrine-related tumors. We were founded by a dedicated team of scientists with the simple belief that better therapies developed from rigorous innovation can lead to better lives. Our work continues to make a real difference in the lives of patients. We have a prolific discovery engine and a robust preclinical and clinical development pipeline. We are driven by science with a patient-centric and team-oriented culture. Crinetics is known for its inclusive workplace culture. We are also a dog-friendly workplace. This is an exciting time to join Crinetics as we shape our organization into the world's premier fully-integrated endocrine company from discovery to patients. Join our team as we transform the lives of others. Position Summary: The Manager, Patient Recruitment, is responsible for managing and implementing comprehensive, coordinated and efficient subject recruitment and retention strategies to support Crinetics' clinical programs, ensuring on-time enrollment and optimal retention of subjects in Crinetics-sponsored clinical trials. The Manager, Patient Recruitment, will have a primary role in development, execution, and tracking of recruitment and site engagement efforts across studies. Essential Job Functions and Responsibilities: These may include but are not limited to: Manage strategic initiatives for trial-specific patient recruitment and retention efforts for assigned clinical studies. Evaluate recruitment vendors that offer innovative solutions or approaches and oversee the selection and oversight in collaboration with the clinical team. Support the creation of study-specific Subject Recruitment and Retention plans documenting enrollment, engagement, and retention tactics tailored to the needs of the specific study and patient population. Lead cross-functional (e.g., Medical, Legal, and Regulatory) review and approval of study and site-specific recruitment materials, includingcollecting, providing, and communicating feedback on written content and design elements to recruitment vendor. Lead and/or facilitate program and study-specific site engagement plans with cross-functional teams such as Clinical Operations, Medical Affairs, and Clinical Research. Monitor weekly enrollment metrics and work alongside the clinical team to meet/exceed enrollment goals for assigned studies. Establish and apply best recruitment practices and lessons learned across all clinical studies. Assist with developing recruitment content such as newsletters and presentations. Liaise with clinical sites to evaluate site-specific recruitment initiatives and determine the potential ROI, along with clinical team. Perform or support CRAs with outreach as necessary for underperforming clinical sites to evaluate enrollment goals, Proactively developing and documenting solutions and communicating feedback to clinical team. Other duties as assigned. Education and Experience: Required: BS in biological sciences or related discipline with at least 8 years of experience working in the biotechnology/pharmaceutical industry (an equivalent combination of experience and education may be considered). 4+ years of direct patient recruitment related experiences. Prior experience managing third parties and external service providers (worldwide) and consultants. Good understanding of GLPs, GCPs, and ICH Guidelines. Excellent organizational and time management skills and strong attention to detail, with proven ability to handle multiple tasks efficiently and effectively. Excellent computer skills including advanced knowledge in MS Excel, Word, PowerPoint and Outlook. Must be a self-starter who works with minimal supervision. Good business judgment and a strong understanding of the unique aspects of clinical financials. Excellent communication skills, (verbal and written) including the ability to understand and present recruitment information effectively. Works with high sense of accountability/urgency. Excellent planning, organizational and time management skills, including the ability to support and prioritize multiple projects. Solid understanding of drug development and clinical operations. Physical Demands and Work Environment: Physical Activities: On a continuous basis, sit at desk for a long period of time; intermittently answer telephone and write or use a keyboard to communicate through written means. Some walking and lifting up to 25 lbs. may be required. The noise level in the work environment is typically low to moderate. The physical demands described above are representative of those that must be met by an employee to successfully perform the essential functions and responsibilities of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions and responsibilities. Laboratory Activities (if applicable): Biology and chemical laboratory environment experience needed. Environmental health and safety requirements also apply. Travel: You may be required to travel for up to 5% of your time. Equal Opportunity Employer: Crinetics is proud to be an Equal Opportunity Employer. We provide equal employment opportunities to all employees and employment applicants without regard to unlawful considerations of sex, sexual orientation, gender (including gender identity and/or expression), pregnancy, race, color, creed, national or ethnic origin, citizenship status, religion or similar philosophical beliefs, disability, marital and civil union status, age, genetic information, veteran status or any personal attribute or characteristic that is protected by applicable local, state or federal laws. Salary Range The salary range for this position is: $122,000 - $152,000. In addition to your base pay, our total rewards program consists of a discretionary annual target bonus, stock options, ESPP, and 401k match. We also provide top-notch health insurance plans for employees (and their families) to include medical, dental, vision and basic life insurance, 20 days of PTO, 10 paid holidays, and a winter company shutdown.

Please note that this job posting is for an evergreen position and does not represent an active or current vacancy within our organization. We continuously accept applications for this role to build a talent pool for future opportunities. While there may not be an immediate opening, we encourage qualified candidates to submit their resumes for consideration when a suitable position becomes available. Chronic Care Manager Location: Remote Join our mission to help transform healthcare delivery from reactive, episodic care to proactively managed patient care that prevents live-changing problems before they happen for patients with two or more chronic conditions. We believe every patient with chronic disease deserves consistent check-ins, follow-up, and support. The position of the Nurse Chronic Care Coordinator, Remote will perform telephonic encounters with patients on behalf of our partners each month and develops detailed care plans within our care plan templates in the electronic health record. This begins as an Independent 1099 Contractor position but offers the potential to reach full-time W2 employment (with employee benefits). Harris CCM is seeking Nurses to work part-time from their home office while complying with HIPAA privacy laws. You will set your own hours and will not be held to a daily work hour schedule. You will be contracted to work a minimum of 20hrs/wk. Harris CCM wants its team members to have the flexibility to balance their work-life with their home life. Part-time team members will typically need to dedicate an average of 20-30 hours per week to care for their assigned patients. This unique business model allows you to choose what days and what hours of the day you dedicate to care for your patients. The Care Coordinator will be assigned a patient panel based on skill and efficiency level and is expected to carry a patient panel of a minimum of 100 patients per calendar month. Care Coordinators will be expected to complete encounters on 90 percent of the patients they are assigned. Harris CCM utilizes a productivity-based pay structure and pays $10.00 per completed patient encounter up to 99 encounters/month, $10.25/encounter from 100-149 encounters/month, $12/encounter from 150-199 encounters/month, $14/encounter from 200-249 encounters/month, and $16/encounter for >250 encounters/month. Payment tier increases require 3 months consistency to achieve. A patient encounter will take a minimum of 20 minutes (time is cumulative). What your impact will be: The role of the Care Coordinator is to abide by the plan of care and orders of the practice. Ability to provide prevention and intervention for multiple disease conditions through motivational coaching. Develops a positive interaction with patients on behalf of our practices. Improve revenue by creating billable CCM episodes, increasing visits for management of chronic conditions. Develops detailed care plans for both the doctors and patients. The care plans exist for prevention and intervention purposes. Understand health care goals associated with chronic disease management provided by the practice. Attend regularly scheduled meetings (i.e., Bi-Monthly Staff Meetings, monthly one on one's, etc.). These “mandatory” meetings will be important to define the current scope of work. What we are looking for: Graduate from an accredited School of Nursing. (LPN, LVN, RN, BSN, etc.) Current COMPACT license to practice as an RN/ LVN/LPN held in current state of residence with no disciplinary actions noted A minimum of two (2) years of clinical experience in a Med/Surg, Case Management, and/or home health care. Hands-on experience with Electronic Medical Records as well as an understanding of Windows desktop and applications (MIcrosoft Office 365, Teams, Excel, etc), also while being in a HIPAA compliant area in home to conduct Chronic Care Management duties. Ability to exercise initiative, judgment, organization, time-management, problem-solving, and decision-making skills. Skilled in using various computer programs (If you don't love computers, you won't love this position!) High Speed Internet and Desktop or Laptop computer (Has to be operation system of Windows or Mac) NO Chromebooks Excellent verbal, written and listening skills are a must. What will make you stand out: Quickly recognize condition-related warning signs. Organized, thorough documentation skills. Self-directed. Ability to prioritize responsibilities. Demonstrated time management skills. Clear diction. Applies exemplary phone etiquette to every call. Committed to excellence in patient care and customer service. What we offer: Contract position with opportunity to become a full-time position, to include benefit options (Medical, Dental, Vision, 401K, Life). Streamline designed technology for your Chronic Care operations Established and secure company since 1976, providing critical software solutions for many verticals in countries ranging from North America, Europe, Asia, and Australia. Core Values that unite and guide us Autonomous and Flexible Work Environments Opportunities to learn and grow Community Involvement and Social Responsibility About us: For over 20 years GEMMS has been the leader in Cardiology Specific EHR technology. The product was developed in a “living laboratory” of a large Cardiology Enterprise with over 40 physicians in 28 locations. For single physician offices to large cardiovascular centers that include a diagnostic centers, ambulatory surgical center, and peripheral vascular offerings. When physicians and Administrators evaluate GEMMS ONE, they are often impressed with the vast clinical cardiovascular knowledge content and operational aspects found in GEMMS ONE. GEMMS ONE EHR provides a rich array of functionality spanning the entire cycle of patient care. With everything from a patient portal to e-prescribing to clinical documentation to practice management including cardiovascular specific quality measurements and MIPS patient dashboard. GEMMS ONE EHR System provides all the medical records software tools needed to complete your daily tasks in the most efficient way possible. GEMMS ONE is a fully interoperable and integrated application that allows “real time” merging of clinical processes and revenue cycle management. It also can seamlessly connect to external revenue cycle management programs that might be used in larger enterprises so that you can get the efficiency of Cardiovascular Clinical workflow while supporting the revenue cycle requirements of larger enterprises. Complying with governmental regulations and payer requirements will be simplified, while enhancing your operational and financial performance.

This position is a temporary role facilitated through one of our contracted agencies and is not a direct employment opportunity with IEHP. The contracted agency offers an assignment length of up to six months, during which the candidate will provide support for IEHP. What you can expect! Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience! Under the direction of department leadership, this position focuses on a person-centered model of care which takes in to account the Member's medical, behavioral, and social needs. This position provides high quality, effective care management to IEHP members ensuring coordinated continuous care. Care Management is broadly defined, and can include outreach and engagement to members, engaging members in skilled therapeutic interactions to promote health behaviors, other behavioral health interventions within scope, coordination of care, resource linkages, working with other professionals and organizations in the community to ensure quality of care for members, seamless transitions of care, and facilitating the right care and the right time for the member. As a licensed clinician, this position provides clinical expertise, clinical leadership, and clinical oversight in a variety of ways within the department. The individual in this position is to utilize their clinical expertise to support and engage Members to promote positive health behaviors, assist with coordination of care, provided resource linkages, and collaborate with other Team Members within their care team, as well as external partners, to ensure a seamless transitions of care experience. This position is expected to model behavioral health principles of relationship-based care, as well engage in promoting education and understanding of Behavioral health and its importance in whole health, to those within IEHP and in the community. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Education & Requirements * Minimum of three (3) years of experience performing or facilitating Behavioral Health/Medical Social Work services * Experience in motivational interviewing and/or other evidenced-based communication strategies * Experience working successfully within a team, and experience in developing and maintaining effective relationships with both clients and coworkers is mandatory * Master's degree in Social Work or related field from an accredited institution required * Possession of an active, unrestricted, and unencumbered license in a Social Services related field issued by the California Board of Behavioral Sciences required (LCSW or LMFT preferred) Key Qualifications * Must have a valid California Driver's License * Behavioral Health/Medical Social Work services experience in a health clinic psychiatric hospital, medical facility, or health care clinic strongly preferred * Experience in clinical services, both mental health and substance use preferred * Familiarity with providing Behavioral Health Care and discharge planning is required * Knowledgeable and skilled in evidenced-based communication such as Motivational Interviewing, or similar empathy-based communication strategies * Understanding of and sensitivity to multi-cultural communities * Deep understanding and knowledge of mental health and substance use conditions, including both acute and chronic management * Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both * Must have knowledge of whole health and integrated principles and practices * Bilingual (English/IEHP Threshold Language) - written and verbal is highly preferred * Highly skilled in interpersonal communication, including conflict resolution * Effective written and oral communication skills, as well as reasoning and problem-solving skills * Skillful in informally and formally sharing expertise. Must have the resiliency to tolerate and adapt to a moderate level of change and development around new models of care and care management practices * Proficient in the use of computer software including, but not limited to, Microsoft Word, Excel, PowerPoint * Demonstrated proficiency with all electronic medical management systems (e.g., Cisco, MHK/Care Prominence, MediTrac, SuperSearch and Web Portal) is preferred * Proven ability to: * Sufficiently engage Members and providers on the phone as well as in person * Work as a member of a team, executing job duties and making skillful decisions within one's scope * Establish and maintain a constructive relationship with diverse Members, Leadership, Team Members, external partners, and vendors * Prioritize multiple tasks as well as identify and resolve problems * Have effective time management and the ability to work in a fast-paced environment * Be extremely organized with attention to detail and accuracy of work product * Have timely turnaround of assignments expected * To form cross-functional and interdepartmental relationships Start your journey towards a thriving future with IEHP and apply TODAY! Pay Range * $43.87 USD Hourly - $58.13 USD Hourly

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.

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.)

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.

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.

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.

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

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.

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.

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

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.

Full-time Description $500 Referral Bonus $10,000 sign on bonus with current CHUNNY experience The Care Manager will work closely with the Health Homes Care Management Department, the Department of Health, contracted Care Management Agencies (such as CHHUNY), ancillary providers, youth, and family members to successfully carry out care management tasks that link, advocate, and support the overall health and wellness of youth in our comm unities. The Care Manager is responsible for providing linkage and care management support to the youth and family and will be required to complete multiple assessments as required by CHHUNY and the Department of Health including, but not limited to a Plan of Care, Safety, Crisis, and Emergency Plan, Comprehensive Assessment, CANS-NY Assessment, and facilitation of Interdisciplinary Team Meetings. The Care Manager may be required to evaluate, coordinate, and provide necessary referrals for services and/or treatment as described, complete required assessments, and assist youth and families by helping to articulate goals and providing needed information. This person works closely in partnership with the families, foster families, County workers and other community partners. Primary Job Functions Provide overall support to youth to ensure that they are getting the services need to meet the overall health and wellness goals. Demonstrates understanding of the four dimensions of safety and can identify gaps. Demonstrates and models sensitivity to the cultural background of children, families and co-workers. Assures that job-related activities are in compliance with Glove House policies and procedures, Department of Health, Care Management Agencies, State and Federal regulations, and relevant professional association, ethical standards, accreditation standards, and the law. Perform care management tasks as defined by the Department of Health and contracted Care Management Agencies (i.e. CHHUNY) (may include assessments, goal plans, safety plans, and other assessments). Link, advocate, and support youth and families by identifying current strengths and barriers while providing referrals and other interventions to assist with current needs such as psychosocial supports and linkages with medical, dental, and behavioral health care providers, as well as, educational, employment, transportation community resources. Participate as a team member of Health Homes Department and the Finger Lakes Regional Office, supporting other teams when necessary. Coordinate services with other professionals and paraprofessionals and liaise with outside social service agencies and other organizations, where appropriate. Provide comprehensive, client-centered, trauma-informed, collaborative care planning for the development and management with the youth and parent/guardian to assist in the integration of medical and behavioral health services, and social health services. Build and use effective communications strategies among peers, medical staff, addiction and mental health providers, and other community agencies using electronic assisted devices including Telehealth and other interactive technology. Help improve, measure, monitor, and sustain quality outcomes that focus on clinical indicators/performance measures, patient satisfaction, and plan adherence. Participate in interdisciplinary team meetings and conduct regular face-to-face contact with youth and families. May monitor interns and/or volunteers. Develop and maintain records and program documentation, such as assessments, care plans, visitation plans, progress notes and summaries, according to contract and Glove House standards. Generate and maintain necessary reports and paperwork (i.e., Quality Assurance and program reports). Assures all documentation is completed in a timely fashion (within 48 business hours for contacts) Assures that program staff are up to date with any concerns or needs of your case load. Requirements Bachelor's degree required, CHUNNY certification preferred Experience Minimum 2+ years' experience working with children and families in residential, group, or counseling child welfare capacity.

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.

supporting Louisiana. Candidates must be licensed in Louisiana. Under general supervision, and in collaboration with other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided in inpatient and/or outpatient care settings. Collects and analyzes utilization data. Assists with discharge planning and care coordination. Provides member assistance with mental health and substance abuse issues, and participates in special quality improvement projects. Monitors inpatient and/or outpatient level of care services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness. Provides telephone triage, crisis intervention and emergency authorizations as assigned. Performs concurrent reviews for inpatient and/or outpatient care and other levels of care as allowed by scope of practice and experience. In conjunction with providers and facilities, develops discharge plans and oversee their implementation. Performs quality clinical reviews while educating and making appropriate interventions to advance the care of the member in treatment. Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria. Interacts with Physician Advisors to discuss clinical and authorization questions and concerns regarding specific cases. Participates in quality improvement activities, including data collection, tracking, and analysis. Maintains an active work load in accordance with National Care Manager performance standards. Works with community agencies as appropriate. Proposes alternative plans of treatment when requests for services do not meet medical necessity criteria. Participates in network development including identification and recruitment of quality providers as needed. Advocates for the patient to ensure treatment needs are met. Interacts with providers in a professional, respectful manner that facilitates the treatment process. The job duties listed above are representative and not intended to be all-inclusive of what may be expected of an employee assigned to this job. A leader may assign additional or other duties which would align with the intent of this job, without revision to the job description. Other Job Requirements Responsibilities Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements. One or more of the following licensure is required for this role with necessary degrees: CEAP, LMSW, LCSW, LSW, LPC or RN. Minimum 2 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting. Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community resources and providers. Knowledge and experience in inpatient and/or outpatient setting. Knowledge of DSM V or most current diagnostic edition. Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care. General Job Information Title Care Manager, BH - Remote (Louisiana license required) Grade 24 Work Experience - Required Clinical Work Experience - Preferred Education - Required Associate - Nursing, Bachelor's - Social Work, Master's - Social Work Education - Preferred License and Certifications - Required CEAP - Certified Employee Assistance Professional - Care MgmtCare Mgmt, LCSW - Licensed Clinical Social Worker - Care MgmtCare Mgmt, LMFT - Licensed Marital and Family Therapist - Care MgmtCare Mgmt, LMSW - Licensed Master Social Worker - Care MgmtCare Mgmt, LPC - Licensed Professional Counselor - Care MgmtCare Mgmt, LSW - Licensed Social Worker - Care MgmtCare Mgmt, RN - Registered Nurse, State and/or Compact State Licensure - Care MgmtCare Mgmt License and Certifications - Preferred Salary Range Salary Minimum: $58,440 Salary Maximum: $93,500 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.

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.