Geriatric Care Manager jobs at MaineGeneral Health

The Case Manager III (CM III), a key member of the primary care interdisciplinary team, provides services for patients with complex care needs. This position conducts patient outreach, engagement and psychosocial service assessment, assists in developing a patient-centered care plan, is the lead implementer of Enhanced Case Management (ECM) and coordinates service referrals and delivery. The case manager meets clients in home, clinic, or community as appropriate or required by the specific program/site. The CM III provides services to specific populations that have multiple complex health and social services needs and often provides care outside of a traditional health center setting, such as home visits, hospitals, supportive housing sites, encampments and shelters. In addition they provide comprehensive housing navigation support to clients. This is a grant funded, full time, benefit eligible opportunity, at our Oakland locationS (Medical Respite & Street Medicine) This position is represented by SEIU-UHW. Salaries and benefits are set by a collective bargaining agreement (CBA), and an employee in this position must remain a member in good standing of SEIU-UHW, as defined in the CBA. LifeLong Medical Care is a large, multi-site, Federally Qualified Health Center (FQHC) with a rich history of providing innovative healthcare and social services to a wonderfully diverse patient community. Our patient-centered health home is a dynamic place to work, practice, and grow. We have over 15 primary care health centers and deliver integrated services including psychosocial, referrals, chronic disease management, dental, health education, home visits, and much, much more. Benefits Compensation: $29.20 - $33.85/hour. We offer excellent benefits including: medical, dental, vision (including dependent and domestic partner coverage), generous leave benefits including ten paid holidays, Flexible Spending Accounts, 403(b) retirement savings plan. Responsibilities Outreach, via telephone and in person at LifeLong, community and residential sites, to patients who meet case management program eligibility criteria or are prioritized by LifeLong for this service Proactively meet and engage with patients to build effective relationships and assess strengths and needs through use of standard intake, screening tools, and health, and social services records review Actively involve patients and caregivers, as appropriate, in designing and delivering services, including development of care plans, assuring alignment with patients' values and expressed goals of care Provide and facilitate referrals for internal and external resources, and collaborate with the patient to complete required applications, forms, or releases of information Maintain a patient caseload in accordance with LifeLong standards for the specific population served or site requirements Utilize data registries and reports to manage caseload, meet program requirements, maintain grant deliverables, and promote high quality care Provide health education and training to patients, including but not limited to, harm reduction and disease risk-mitigation strategies that empower patients to manage their own health and wellness (e.g. overdose prevention, mitigating spread of communicable diseases) Assist patients with accessing and retaining public benefits and insurance (e.g. MediCal, SSI/SSDI, CalFresh, General Assistance), and affordable/subsidized housing Respectfully and routinely communicate with patients, their care team members, external partners, and identified social supports Maintain knowledge of patients' medical/behavioral health treatment plans and facilitate utilization of services by providing resources such as accompaniment, transportation, in-home care, reminder calls etc. Participate in team meetings to coordinate care, support patient goals, and reducing barriers to accessing services Provide case management services to patients with multiple complex acute or chronic medical or behavioral health conditions (e.g. HIV/AIDS, Hep C, congestive heart failure, severe diabetes, severe hypertension, psychosis, pregnancy, and homelessness) Provide general housing case management services that includes document readiness, housing problem solving, and assessments for Coordinated Entry System Assess patients to identify cognitive and/or behavioral health needs and provide brief interventions and short-term support using standardized tools and effective approaches for patient care Co-facilitate patient groups Provide intensive case management to a caseload size in accordance with site or program standards focusing on a subset of the highest acuity patients Provide specialized housing navigation services to patients who are matched to a housing resource through Coordinated Entry System Lead crisis intervention response, de-escalation procedures, notification of the local mental health department and/or crisis response team, and follow-up care Provide and document billable services to eligible populations that result in revenue generation for LifeLong Advocate on behalf of patients to get their needs met and/or support patients to learn advocacy strategies for themselves. Keep current on community resources and social service supports to effectively serve the target population Document patient contacts/services in required data systems (EHR, HMIS etc.) according to LifeLong policy Specific activities may vary depending on the requirements of the program and funder. Promote diversity, equity, inclusion, and belonging in support of patients and staff Represent LifeLong positively in the community and advocate on behalf of underserved populations Qualifications Commitment to working directly with low-income persons from diverse backgrounds in a culturally responsive manner Commitment to harm reduction, recovery, housing first, age-friendly and patient centered care Strong organizational, administrative and problem-solving skills, and ability to be flexible and adaptive to change while maintaining a positive attitude Excellent interpersonal, verbal, and written skills Ability to prioritize tasks, work under pressure, and complete assignments in a timely manner Ability to seek direction/approval on essential matters, yet work independently, using professional judgment and diplomacy Works well in a team-oriented environment Conducts oneself in external settings in a way that reflects positively on your employer Ability to be creative, mature, proactive, and committed to continual learning and improvement in professional settings Job Requirements High School diploma or GED At least three (3) years of progressively responsible work or volunteer experience in a community-based health care or social work setting or at least one (1) year of experience as a Case Manager II or equivalent position or registration or certification as a Certified Alcohol and Drug Counselor by one of the two certifying bodies in California Proficient skills using Microsoft Office applications like Word, Excel, and Outlook, as well as the ability to work in and/or manage databases Access to reliable transportation with current license and insurance Bilingual English/Spanish Job Preferences Bachelor's Degree in Social Work, Health or Human Services field Lived experience of homelessness, incarceration, foster care, mental health services, substance use services or addiction, or as a close family member of someone who has this experience

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

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. Key Responsibilities Establish and continuously model supportive and collaborative relationships with members, colleagues, and external partners. Model the highest ethical behavior in care for Members, as well as in relationships with co-workers, Leaders, internal, and external partners. Model commitment to continuous quality improvement by engaging in quality improvement initiatives and projects, such as by identifying and addressing HEDIS gaps, and by identifying, developing, and testing new practices for improving the outcomes of the Enhanced Care Management team. Participates in Health Plan staff meetings, trainings, committee meetings, or other activities as needed or as directed by Leadership Team Members. Working in a lead training capacity by providing formal and informal clinical training and other learning and development activities to support department Team Members on behavioral health conditions, including treatments and evidence-base for treatment (within areas of expertise/scope) as well as provide onboarding and ongoing training to department Team Members. Promote a collaborative and effective working environment within the department or those outside BH discipline by engaging in evidenced-based communication strategies (such as Motivational Interviewing) when discussing responsibility/sharing of tasks, effectively resolving conflicts as they arise, and collaborating on Member case discussions to provide integrated care to IEHP members. Participate in committees, conferences, and any other meetings as required or directed by department managers or directors. Responsible for primarily working with a caseload of Members with behavioral health needs. Advocate for Members to receive the highest quality care, in a timely manner, within IEHP's network by referring to appropriate internal partners such as behavioral health, Enhanced Care Management, and complex care management. In conjunction with department leadership, the Licensed Behavioral Health Care Manager is responsible for providing consultation for the non-licensed Members of the team when discussing tasks of a clinical nature. Responsible for engaging with Members to provide effective care management, both in-person and on the phone, including linkage to resources and support in transitions of care, in a manner that utilizes evidence-based approaches (such as Motivational Interviewing) that promotes collaboration between the Member and his or her medical/behavioral team, facilitating member self-efficacy and self-management to improve the Member's ability to manage their own health, and all other activities associated with high quality, evidenced-based care management. Ensures documentation is accurate and in compliance with regulatory requirements and accreditation standards. Assist Members with care coordination needs, including, but not limited to the following: Conduct comprehensive, holistic assessment both telephonically as well as in person (facility or home visits). Assimilate assessment information to assist, in collaboration with the ITC Team and the facility, in developing a discharge plan or an individualized care plan (ICP). Communicate ICP or discharge plan with Member, approved family or caregiver and other Members of the care team. Coordinate with internal and external health partners to support Members' comprehensive care needs. Assists with the coordination of medical and behavioral health access issues with PCP offices, specialists, and ancillary services. Participate in inter/transdisciplinary care team meetings to share information, update and inform care plan. Participate and lead (as necessary) care transition plan responsibilities. Engage in proactive, member-centered utilization and quality review of Behavioral Health services by members. Provide crisis intervention to individuals, as well as providing support and clinical guidance to others who engage in this work. Responsible for any other duties as required to ensure successful care management processes and Member outcomes. Provide transitional care services to Members transitioning from one care setting to the next such as assisting the Member with PCP appointments, transportations, and coordination of DME and home health. Support Member through all care transitions by making outreach to ensure all care needs are met before closing the Member out to transitions of care. providing care coordination, linkage to resources, and facilitating Member self-efficacy and self-management. Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications 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! Work Model Location Telecommute Pay Range USD $43.87 - USD $58.13 /Hr.

Job Description Fort Health is a mental health company that is on a mission to “Opening more paths to better care for more families”. We're all about making a real difference in the lives of children and adolescents. With a whopping 50% of kids in the US missing out on mental health care, we're determined to change that statistic. And with a market size of over $50 billion, we're not just dreaming big - we're making it happen! Our vision? Picture this: a world where every child has access to the support they need to thrive mentally and emotionally. With the help of our amazing partners, like the Child Mind Institute, we're creating a one-of-a-kind support system that combines digital tools with virtual clinicians. Because at Fort Health, we believe “we're stronger together”. About the Role: We know that clinicians are the backbone of our company. Everything we do incorporates a clinicians' mindset so that we can provide them with the best job experience, so that they can provide our patients with the best treatment. The Collaborative Care Model (CoCM) is an innovative approach to partnering with the patient, their family, pediatrician, and a psychiatric consultant to target mental health concerns in the primary care setting based on a population-based approach. As part of our CoCM team, you will be an key member of an integrated multidisciplinary team that is responsible for delivering high-quality, evidenced-based mental health care for children, adolescents and their families. You will be responsible for supporting and coordinating care for a caseload of patients with the primary care provider, consulting psychiatrist, and potentially other mental health providers and educational professionals. You will build relationships with the primary care providers and support facilitation of referrals. You will also provide 1:1 brief psychosocial interventions and coaching sessions with patients, families and caregivers, and track the patient's symptoms and progress with validated measures. The Behavioral Health Care Manager works with the CoCM team to provide personalized, holistic treatment plans for each family. The Behavioral Health Care Manager goes through a training program created and led by the AIMS Center at the University of Washington, the leading organization in implementing the Collaborative Care Model. Lastly, we are looking for someone who wants to be a part of a growing healthcare startup that is focused on broadening access to affordable, high-quality mental health care for children and their families! In this role, you will: Screen and assess patients for common mental health disorders, facilitate patient engagement and follow-up care. Provide patient education about common mental health disorders and the available treatment options. Systematically track treatment response and monitor patients for changes in clinical symptoms and treatment side effects or complications. Support psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment. Provide brief behavioral interventions using evidence-based techniques (e.g., problem-solving treatment, motivational interviewing, behavioral activation). Identify appropriate resources and coordinate referral processes to community resources when appropriate. Participate in regularly scheduled caseload consultation with the psychiatric consultant and communicate resulting treatment recommendations to the patient's medical provider. Collaborate with the Collaborative Care team to provide personalized treatment plans for every child and their family. Communicate and work with the family to drive the treatment plan forward. Track patient follow up and clinical outcomes using a registry and document patient progress and treatment recommendations in the electronic health record Develop and complete relapse prevention self-management plan with patients who have achieved their treatment goals and are soon to be discharged from the caseload. Participate in individual supervision with a psychologist to ensure you have the support you need to be successful Expand and strengthen your clinical skills through the AIMS center, and take advantage of additional ongoing training and educational opportunities, conferences, and more. Salary: $70,000 to $80,000 annually based on experience Example Schedule: Monday: 11:30 AM - 7:30 PM Tuesday: 11:00 AM - 7:00 PM Wednesday: 10:00 AM - 6:00 PM Thursday: 11:00 AM - 7:00 PM Friday: 9:30 AM - 5:30 PM There is some flexibility, but preferably one night until 7:30 PM, two nights until 7:00 PM, one night until 6:00 PM, and Friday until 5:30 PM. You can pick work remotely on Fridays if desired. Your time will be spent supporting practices and will require you be on-site at the following location: 1600 Chapel Ave W #100, Cherry Hill Township, NJ 08002 What we are looking for: Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Counselor (LPC), Licensed Mental Health Counselor (LMHC), or advanced practice psychiatric practitioner (NP) Licensed independently to practice Minimum 1-year of direct clinical experience working with children, adolescents and their families Experience and training in delivering brief psychosocial evidence-based treatments (e.g., CBT, problem solving treatment, behavioral activation, motivational interviewing) Experience with care coordination Preferred experience working in a team-based healthcare setting Experience with screening for common mental health disorders and symptom assessment with children and adolescents using measurement-based care tools (e.g., PHQ-9, GAD-7, SCARED, etc.) Working knowledge of differential diagnosis of common mental health disorders. Strong skills in engaging parents and children, developing appropriate treatment planning, and ability to collaborate and communicate effectively in a team setting Desire to work with and learn from some of the top child mental health experts in the field Why join us? Competitive compensation package Generous paid time off including paid company holidays, mental health days1 Paid week of company-wide shutdown between Christmas and New Year's Day Ability to be part of a startup and help build a new treatment model Collaborative and supportive mission-oriented work environment Powered by JazzHR f01D2fqHi9

Fort Health is a mental health company that is on a mission to “Opening more paths to better care for more families”. We're all about making a real difference in the lives of children and adolescents. With a whopping 50% of kids in the US missing out on mental health care, we're determined to change that statistic. And with a market size of over $50 billion, we're not just dreaming big - we're making it happen! Our vision? Picture this: a world where every child has access to the support they need to thrive mentally and emotionally. With the help of our amazing partners, like the Child Mind Institute, we're creating a one-of-a-kind support system that combines digital tools with virtual clinicians. Because at Fort Health, we believe “we're stronger together”. About the Role: We know that clinicians are the backbone of our company. Everything we do incorporates a clinicians' mindset so that we can provide them with the best job experience, so that they can provide our patients with the best treatment. The Collaborative Care Model (CoCM) is an innovative approach to partnering with the patient, their family, pediatrician, and a psychiatric consultant to target mental health concerns in the primary care setting based on a population-based approach. As part of our CoCM team, you will be an key member of an integrated multidisciplinary team that is responsible for delivering high-quality, evidenced-based mental health care for children, adolescents and their families. You will be responsible for supporting and coordinating care for a caseload of patients with the primary care provider, consulting psychiatrist, and potentially other mental health providers and educational professionals. You will build relationships with the primary care providers and support facilitation of referrals. You will also provide 1:1 brief psychosocial interventions and coaching sessions with patients, families and caregivers, and track the patient's symptoms and progress with validated measures. The Behavioral Health Care Manager works with the CoCM team to provide personalized, holistic treatment plans for each family. The Behavioral Health Care Manager goes through a training program created and led by the AIMS Center at the University of Washington, the leading organization in implementing the Collaborative Care Model. Lastly, we are looking for someone who wants to be a part of a growing healthcare startup that is focused on broadening access to affordable, high-quality mental health care for children and their families! In this role, you will: Screen and assess patients for common mental health disorders, facilitate patient engagement and follow-up care. Provide patient education about common mental health disorders and the available treatment options. Systematically track treatment response and monitor patients for changes in clinical symptoms and treatment side effects or complications. Support psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment. Provide brief behavioral interventions using evidence-based techniques (e.g., problem-solving treatment, motivational interviewing, behavioral activation). Identify appropriate resources and coordinate referral processes to community resources when appropriate. Participate in regularly scheduled caseload consultation with the psychiatric consultant and communicate resulting treatment recommendations to the patient's medical provider. Collaborate with the Collaborative Care team to provide personalized treatment plans for every child and their family. Communicate and work with the family to drive the treatment plan forward. Track patient follow up and clinical outcomes using a registry and document patient progress and treatment recommendations in the electronic health record Develop and complete relapse prevention self-management plan with patients who have achieved their treatment goals and are soon to be discharged from the caseload. Participate in individual supervision with a psychologist to ensure you have the support you need to be successful Expand and strengthen your clinical skills through the AIMS center, and take advantage of additional ongoing training and educational opportunities, conferences, and more. Salary: $70,000 to $80,000 annually based on experience Example Schedule: Monday: 11:30 AM - 7:30 PM Tuesday: 11:00 AM - 7:00 PM Wednesday: 10:00 AM - 6:00 PM Thursday: 11:00 AM - 7:00 PM Friday: 9:30 AM - 5:30 PM There is some flexibility, but preferably one night until 7:30 PM, two nights until 7:00 PM, one night until 6:00 PM, and Friday until 5:30 PM. You can pick work remotely on Fridays if desired. Your time will be spent supporting practices and will require you be on-site at the following location: 1600 Chapel Ave W #100, Cherry Hill Township, NJ 08002 What we are looking for: Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Counselor (LPC), Licensed Mental Health Counselor (LMHC), or advanced practice psychiatric practitioner (NP) Licensed independently to practice Minimum 1-year of direct clinical experience working with children, adolescents and their families Experience and training in delivering brief psychosocial evidence-based treatments (e.g., CBT, problem solving treatment, behavioral activation, motivational interviewing) Experience with care coordination Preferred experience working in a team-based healthcare setting Experience with screening for common mental health disorders and symptom assessment with children and adolescents using measurement-based care tools (e.g., PHQ-9, GAD-7, SCARED, etc.) Working knowledge of differential diagnosis of common mental health disorders. Strong skills in engaging parents and children, developing appropriate treatment planning, and ability to collaborate and communicate effectively in a team setting Desire to work with and learn from some of the top child mental health experts in the field Why join us? Competitive compensation package Generous paid time off including paid company holidays, mental health days1 Paid week of company-wide shutdown between Christmas and New Year's Day Ability to be part of a startup and help build a new treatment model Collaborative and supportive mission-oriented work environment

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! The Behavioral Health Care Manager, SKI (Specialty Kids Intervention) BCBA is responsible for all aspects of services to IEHP members with autism, developmental disabilities, and/or intellectual disabilities and children with severe behavioral needs. The Behavioral Health Care Manager, SKI BCBA will also be responsible for reviewing requests for services, applying clinical criteria, applying clinical expertise to review treatment plans and authorizing services to ensure quality care coordination. This position ensures effective call support, case management as needed, care coordination as needed, and referral support. Under the direction of department leadership, the Behavioral Health Care Manager, SKI BCBA position works collaboratively with members of their own team, IEHP members and families, community agencies, and with the designated health care organization (HCO) medical team. This position is expected to model IEHP 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. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary Hybrid schedule State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account - Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Adhere to the ethical guidelines of the BACB Board. Provide support to the SKI team to ensure implementation of timely processes, follow-through of calls, task completion, and case management functions. Provide guidance in the realm of autism, developmental disabilities, and behavior analytic practices for the SKI team and all departments, when needed. Work with BHT providers and other providers (Primary Care, Speech Therapist, etc) within the IEHP network; develop genuine and effective relationships with providers. Participate in clinical review meetings for Members regarding behavioral concerns, barriers to treatment or treatment progress, as needed. Ensure treatment plans are updated, assessment results are updated, the treatment goals align to the assessment results and that goals meet medically necessary criteria. Become proficient in all electronic medical management systems (e.g. Cisco, MedHOK, HSP, Super Search and Web Portal) to assist in training of new staff members. Review requests for services, apply clinical criteria, and apply clinical expertise to review treatment plans and authorizing services. Participates in Health Plan staff meetings, trainings, committee meetings, or other activities as needed or as directed by Leadership Team Members. Participate in other committees as needed, Interdisciplinary Care Conferences, and any other meetings as required or directed by department managers or Directors. Work with a caseload of Members with developmental delays as needed. In conjunction with department leadership, provide consultation for the non-certified/licensed team members when discussing tasks of a clinical nature. Ensures documentation is accurate and in compliance with regulatory requirements and accreditation standards. Perform any other duties as required to ensure Health Plan operations and department business needs are successful. Qualifications Education & Requirements Three (3) years of experience working in a setting offering services to individuals with autism, developmental or intellectual disabilities required Significant experience reviewing Behavioral Health Treatment Plans and Behavior Intervention Plans (BIPs) Experience in leading a team is preferred Experience in an HMO or experience working in psychiatric facility or county hospital facility preferred Master's degree in Social Work/Psychology or related field from an accredited institution with ABA specialization required Possession of an active, unrestricted, and unencumbered Board-Certified Behavior Analyst (BCBA) certification issued by the Behavior Analyst Certification Board required Key Qualifications Deep knowledge and skills in Autism; Applied Behavioral Analysis, Special Education skills in engaging and serving families Familiarity with Managed Care and discharge planning is preferred 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 Awareness of the impact of unmitigated bias and judgement on health; commitment to addressing both Must have knowledge of whole health and integrated principles, theories, and practices Knowledge of community resources and health plan benefits Bilingual written and verbal is highly preferred Skillful at telephonic information delivery and counseling support to Members, their caregivers, and their families Effective reasoning and problem-solving skills Excellent relationship, communication (written and verbal), and interpersonal skills, including conflict resolution Must have resiliency to tolerate, adapt, and manage effective use of a high level of ambiguity around new team models, new models of care, and new care management practices Proficient in the use of computer software to include but not limited to: (e.g. Microsoft Word and Excel, Power Point) for use in all aspects of an office environment Excellent organizational skills while effectively multi-tasking on various projects Ability to undertake and write telephonic clinical mental health assessments which meet specified regulatory standards. Ability to interview, assess, and coordinate care Skilled in researching applicable resources for members Demonstrated proficiency with all electronic medical management systems (e.g., Cisco, MHK/Care Prominence, MediTrac, SuperSearch and Web Portal) is preferred Proven ability to: Work as a member of a highly autonomous team, executing job duties and making skillful decisions as an independent team member within one's scope Show desire and develop genuine, effective relationships with members, co-workers, supervisors, and community/HCO partners at all levels Support others to utilize telephonic means to engage, assess and assist members is required Provide vision, leadership, and support to a team Communicate and work effectively with a variety of providers and maintain positive working relationships with internal and external contacts at all levels Show a high degree of patience Learn new computer systems Prioritize multiple tasks as well as identify and resolve problems Have effective time management and the ability to work in a fast-paced environment Have timely turnaround of assignments expected To form cross-functional and interdepartmental relationships Work Location is dependent on department leadership and business need. Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location Telecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership) Pay Range USD $91,249.60 - USD $120,910.40 /Yr.

Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: Yes We are seeking a strategic and experienced leader to oversee our Reimbursement Services team. This role is responsible for guiding the planning, analysis, and implementation of reimbursement methodologies for healthcare providers. The ideal candidate will manage both short- and long-term reimbursement initiatives, collaborate with senior leadership to align financial strategies, and lead forecasting efforts to assess the impact of reimbursement changes. Additionally, this position provides daily support for coding and reimbursement needs across negotiations, claims processing, and provider setup. A minimum of one certification is required: CPC, CRC, or RHIT. Job Duties: Oversees the Reimbursement Services team members who lead the planning, analysis, consultation and direction of the reimbursement methodology for healthcare providers. Oversees short and long term reimbursement initiatives with the ability to work closely with senior management to develop strategic goals and implement reimbursement initiatives. Leads the forecasting process related to changes in reimbursement methodology and associated financial impact. Oversees daily coding and reimbursement support to negotiations, claims processors and provider set-up representatives. A minimum of one certification is required: CPC, CRC, or RHIT. Coordinates and provides oversight for the ongoing analysis and planning of industry reimbursement changes. Coordinates ongoing physician fee changes and primary care capitation analysis. Provides impact analysis as fee changes occur. Coordinates the ongoing fee revision process. Ensures efficient and timely processing of problem claims for all lines of business and all markets, including new and expansion markets. Monitors and evaluates provider-specific payment waivers and distinctive edit exclusions negotiated within the provider network. Consultative activities with internal and external customers to assist with the development of reimbursement strategies related to TPA or new market relationships. Provides consultative support on all financial planning issues related to provider reimbursement. Evaluates reimbursement initiatives and changes in payment to control medical expense. Leads implementation of new or existing predictive modeling software tools, as well as, supports the accuracy and integrity of reimbursement related information. Assists with presentations to provider network managers to educate on industry trends in reimbursement, reimbursement changes and tools and templates available for requesting reports on historical provider reimbursement. Ensures that accurate predictive modeling is done by line of business (Medicare versus Commercial). Recommends reimbursement opportunities by utilizing statistical reports, reimbursement summary documents and industry information to conduct review and analysis of coding practices or fee levels. Determines appropriateness of provider coding and charging practices and associated claims processing payment accuracy to validate actual provider payment against contracted payment terms. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. #LI-REMOTE Position Details: Education: Bachelor's Degree- (Required), Bachelor's Degree-Business Administration/Healthcare Management (Preferred) Experience: Minimum of 3 years-Managing people, processes, or projects (Required) Certification(s) and License(s): Certified Professional Coder - American Academy of Professional Coders (AAPC), Certified Risk Adjustment Coder - American Academy of Professional Coders (AAPC), Registered Health Information Technician (RHIT) - American Health Information Management Association Skills: Builds Relationships, Computer Literacy, Manages Conflict And Crisis, Manages Projects And Functions, Mathematics OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. SAFETY: We provide a safe environment for our patients and members and the Geisinger family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality. We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

PURPOSE: The Attendant Care Department Manager provides support to company leadership, ensures compliance with applicable regulations and policies, and promotes quality service delivery. This role requires adept management of remote and traveling employees, oversight of an administrative team, and coordination with field staff to meet in-person service requirements. The Manager embraces a systems-oriented approach, continuous improvement mindset, and coaching leadership style. MINIMUM QUALIFICATIONS Bachelor's degree or a combination of 5 years' experience and education in the field of education, social work, disability services, or a related field Minimum 3-5 years' relevant work experience, preferably in a Human Services field Experience supervising remote and/or field-based employees. Satisfactory background check Ability to obtain DPS fingerprint clearance card Proficient in Microsoft Office (Word, Excel, Outlook) and comfortable working with internal databases and large data sets. Familiarity with state and federal regulations related to attendant care services, including AHCCCS and DDD requirements. Key Competencies Strong leadership and team coordination, including support for remote and field staff Ability to manage complex systems, priorities, and workflows Clear, professional communication with teams and stakeholders Highly organized with strong accountability and follow-through Skilled in analyzing reports and large data sets to ensure compliance Strong critical thinking and problem-solving abilities Commitment to continuous improvement and process efficiency Self-directed and reliable in remote settings, with flexibility to travel Essential Job Functions Manage ATC Monitor schedules and ensure timely completion of required visits. Oversee staff hiring, training, supervision, and certification compliance. Coordinate payroll processes, incentive payments, and caseload assignments. Monitor visit quality, vehicle compliance, and staff adherence to policies. Lead department meetings and support communication across teams. Maintain accurate records and respond to audits or compliance requests. Ensure confidentiality, safety, and adherence to all organizational and regulatory standards EQUIPMENT Computer Internet Multi-functional printer/scanner Cell Phone May require the use of vehicle WORK ENVIRONMENT This job operates as a remote telecommuting position, as Arion Care Solutions does not provide a separate workplace at a corporate location. Working from home requires a high degree of discipline and the ability to have a space dedicated to work in the home and provision for childcare if appropriate. This position may require travel to different locations and in-person meetings. Arion Care Solutions, LLC is an equal opportunity employer.

Description: General Description: The Lead Care Manager is responsible for coordinating and delivering Care Management and related care coordination services for patients with multiple chronic conditions. This position focuses on building trusting relationships with patients, developing individualized care plans, and collaborating with the patient's care team to improve health outcomes, reduce avoidable hospitalizations, and enhance patient engagement. In addition to core care management duties, the Lead Care Manager serves as a mentor and clinical resource for newly hired care managers, assists in onboarding and training, supports the Chronic Care Management Coordinator in resolving operational issues, and provides coverage during CCM Coordinator's absence. This role also contributes to strategic planning and quality improvement initiatives within the Care Management Programs. The role is primarily remote, using phone, electronic health record (EHR) tools, and telehealth platforms to provide services. Duties and Responsibilities: Provide monthly care management services for assigned patients in accordance with CMS guidelines. Perform comprehensive assessments, including medical, social, functional, and behavioral health needs. Develop, implement, and update patient-centered care plans with input from patients, families, and providers. Conduct monthly billable check-ins, track cumulative time, and ensure accurate, timely, and compliant documentation of all patient interactions in EHR. Coordinate care across providers, specialists, hospitals, and community resources. Support Remote Patient Monitoring (RPM) initiatives by reviewing data, identifying trends, and intervening as needed. Provide health coaching and patient education related to chronic disease management. Monitor and address care gaps, preventative screenings, and medication adherence. Identify and escalate high-risk patients for provider review. Participate in quality improvement initiatives related to care management and population health. Provide Mentorship for Care Managers. Train and orient new Care Managers. This may mean time in office vs. remote. Provides coverage and serves as point of contact in the absence of CCM Coordinator. Operational support during program startup. Observing and giving strategic input on workflows and quality initiatives. Reporting Relationships Responsible to: Directly supervised by the Chronic Care Management Coordinator Workers Supervised: None Interrelationships: Interacts directly with patients and family members via telephone or MyChart. Represents CHC and the practice site to the public in a professional manner. Works closely with CCM team, Quality and Population Health team, Administrative Leaders and Directors, and providers and staff at all clinics. This job description is not designed to cover or contain an exhaustive list of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time, with or without notice. Requirements: Requirements: All employees of Carolina Health Centers, Inc. are expected to perform the duties of their job and behave in a manner consistent with the Corporate Philosophy which supports the values of: honesty, integrity, openness, the pursuit of individual and collective excellence, and unwavering mutual respect and appreciation. In addition, this position requires: Education: ADN or BSN (BSN preferred) Licensure and Credentials: Current, unrestricted nursing license in South Carolina or a compact state. Work Experience: Minimum 2 years of nursing experience, preferably in primary care, care management, case management, or chronic disease management. Skills: Able to read, write and communicate effectively orally and in writing Proficient in use of computer and keyboard Proficiency in using electronic health records (EPIC preferred) Able to establish and maintain effective working relationships Excellent interpersonal and communication abilities Strong communication skills and ability to build rapport with patients remotely. Ability to work independently, manage time effectively, and prioritize patient needs. Knowledge of CMS billing guidelines and documentation standards for care management programs. Experience with telehealth, remote patient monitoring, or population health programs. Physical Abilities: Have the hand-eye coordination and manual dexterity needed to operate a computer, telephone, copier, standard office equipment, and medical equipment. Required to talk and have a normal range of hearing and eyesight to be able to collect data and record where appropriate (i.e. computer and/or paper). Vision abilities required for this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus Work Environment: Reliable internet access and private, HIPPA-compliant remote work environment. Remote, work-from-home position with structured daily schedule. Occasional travel to clinics, training, or community events may be required. Computer, phone, and secure access to EHR will be provided. Requirements for out-of-town and/or overnight travel are minimal.

General Description: The Lead Care Manager is responsible for coordinating and delivering Care Management and related care coordination services for patients with multiple chronic conditions. This position focuses on building trusting relationships with patients, developing individualized care plans, and collaborating with the patient's care team to improve health outcomes, reduce avoidable hospitalizations, and enhance patient engagement. In addition to core care management duties, the Lead Care Manager serves as a mentor and clinical resource for newly hired care managers, assists in onboarding and training, supports the Chronic Care Management Coordinator in resolving operational issues, and provides coverage during CCM Coordinator's absence. This role also contributes to strategic planning and quality improvement initiatives within the Care Management Programs. The role is primarily remote, using phone, electronic health record (EHR) tools, and telehealth platforms to provide services. Duties and Responsibilities: * Provide monthly care management services for assigned patients in accordance with CMS guidelines. * Perform comprehensive assessments, including medical, social, functional, and behavioral health needs. * Develop, implement, and update patient-centered care plans with input from patients, families, and providers. * Conduct monthly billable check-ins, track cumulative time, and ensure accurate, timely, and compliant documentation of all patient interactions in EHR. * Coordinate care across providers, specialists, hospitals, and community resources. * Support Remote Patient Monitoring (RPM) initiatives by reviewing data, identifying trends, and intervening as needed. * Provide health coaching and patient education related to chronic disease management. * Monitor and address care gaps, preventative screenings, and medication adherence. * Identify and escalate high-risk patients for provider review. * Participate in quality improvement initiatives related to care management and population health. * Provide Mentorship for Care Managers. * Train and orient new Care Managers. This may mean time in office vs. remote. * Provides coverage and serves as point of contact in the absence of CCM Coordinator. * Operational support during program startup. * Observing and giving strategic input on workflows and quality initiatives. Reporting Relationships Responsible to: * Directly supervised by the Chronic Care Management Coordinator Workers Supervised: * None Interrelationships: * Interacts directly with patients and family members via telephone or MyChart. * Represents CHC and the practice site to the public in a professional manner. * Works closely with CCM team, Quality and Population Health team, Administrative Leaders and Directors, and providers and staff at all clinics. This job description is not designed to cover or contain an exhaustive list of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time, with or without notice. Requirements Requirements: All employees of Carolina Health Centers, Inc. are expected to perform the duties of their job and behave in a manner consistent with the Corporate Philosophy which supports the values of: honesty, integrity, openness, the pursuit of individual and collective excellence, and unwavering mutual respect and appreciation. In addition, this position requires: * Education: * ADN or BSN (BSN preferred) * Licensure and Credentials: * Current, unrestricted nursing license in South Carolina or a compact state. * Work Experience: * Minimum 2 years of nursing experience, preferably in primary care, care management, case management, or chronic disease management. * Skills: * Able to read, write and communicate effectively orally and in writing * Proficient in use of computer and keyboard * Proficiency in using electronic health records (EPIC preferred) * Able to establish and maintain effective working relationships * Excellent interpersonal and communication abilities * Strong communication skills and ability to build rapport with patients remotely. * Ability to work independently, manage time effectively, and prioritize patient needs. * Knowledge of CMS billing guidelines and documentation standards for care management programs. * Experience with telehealth, remote patient monitoring, or population health programs. * Physical Abilities: * Have the hand-eye coordination and manual dexterity needed to operate a computer, telephone, copier, standard office equipment, and medical equipment. * Required to talk and have a normal range of hearing and eyesight to be able to collect data and record where appropriate (i.e. computer and/or paper). * Vision abilities required for this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus * Work Environment: * Reliable internet access and private, HIPPA-compliant remote work environment. * Remote, work-from-home position with structured daily schedule. * Occasional travel to clinics, training, or community events may be required. * Computer, phone, and secure access to EHR will be provided. * Requirements for out-of-town and/or overnight travel are minimal.

The Clinical Care Manager provides immediate support for individuals experiencing suicidal thoughts, mental health or substance use crises, and other emotional distress. Our call center also supports Access Crisis Intervention (ACI), EPICC (Engaging Patients in Care Coordination), and other behavioral health business lines. As a part time Clinical Care Manager, you will serve as the first point of contact for individuals in crisis by providing evidence-based assessment, intervention, and referral services. Clinical Care Managers work within a clinical framework to ensure safety, stabilization, and linkage to ongoing care when appropriate. Key Responsibilities: Answer incoming 988, ACI, EPICC, and other designated behavioral health lines. Conduct thorough risk assessments for suicide, self-harm, substance use, and other crisis situations. Provide crisis intervention, stabilization, and safety planning using best-practice models. Determine appropriate level of care and coordinate warm handoffs or referrals to community partners, crisis teams, or treatment providers. Engage in follow-up and care coordination when required by program protocols. Accurately document all contacts in compliance with agency, state, and federal requirements. Maintain strict adherence to confidentiality, HIPAA, and Lifeline standards. Participate in case consultation, clinical supervision, and ongoing professional development. Qualifications: Minimum of a bachelor's degree in psychology, social work, counseling, or related behavioral health field required (master's preferred). Licensed or license-eligible clinicians (e.g., LPC, LCSW, LMFT, LMSW) strongly preferred. Minimum of three years' experience in crisis intervention, behavioral health, or substance use treatment required. Demonstrated ability to apply evidence based clinical judgment handling high stress, fast paced call volume. Proficiency in risk assessment, motivational interviewing, and crisis de-escalation skills. Strong written and verbal communication, with competency in electronic health documentation. Flexibility to work evenings, overnights, weekends, and holidays as needed. Schedule & Compensation: Part-time position with minimum of 16hrs per week, flexible scheduling; evening, overnight, weekend, and holiday availability required. Competitive hourly wage with shift differential for evenings/overnights. Clinical supervision and ongoing training provided. Work Environment: This is a completely remote position once you have successfully completed new hire orientation. Must live within 1hour of the Greater Kansas City Metropolitan area. Must have reliable and secure internet service. Supportive team with access to supervision and staff wellness resources.

Description - Behavioral Health Services Manager Original Board Approval Date 08/26/2020 Reports to Director of Behavioral Health Division Behavioral Health/Administrative Exempt/Non-Exempt Status Exempt Security Roles Clinical Administration; Clinical Care Specialist JOB SUMMARY: The Behavioral Health Services Manager plays a key role in supporting HOPE's integrated care model by helping oversee the day-to-day operations of the Behavioral Health (BH) department. This position provides direct supervision to BH nurses, medical assistants, and other support roles within the department, ensuring high-quality, patient-centered care. The Manager also serves as a vital administrative partner to the Director of Behavioral Health, offering clerical, programmatic, and operational support to help drive departmental goals, improve workflows, and maintain compliance with FQHC standards. Primary Duties & Responsibilities: Clinical Support: Demonstrates proficiency in all aspects of patient triage within the Behavioral Health department and completes competency assessments for both new and existing employees. Serves as a backup for the Behavioral Health medical assistant or nurse during periods of absence to ensure continuity of patient care and clinic operations. Human Resources & Staffing Support: Assists with the orientation and onboarding of new Behavioral Health staff, including interview coordination and preparation of new hire materials. Manages the department's weekly staffing schedule, including time-off approvals, timesheet submissions, missed punch corrections, and payroll approvals using ADP. Organizes and facilitates regular departmental meetings, including preparing agendas and documenting meeting minutes. Quality Improvement & Data Management: Supports departmental quality improvement efforts through data collection, analysis, and reporting. Tracks and reports on key indicators such as patient satisfaction, departmental expenses, and service utilization. Provides feedback and suggestions for process improvement based on insights from staff, patients, and community partners. Collaborates with the Director of Behavioral Health to develop and maintain spreadsheets and databases (e.g., Excel) to support budgeting and quality initiatives. Assists with the maintenance and updates of departmental forms and documentation. Community & Program Development: Educates patients, families, and community partners on available behavioral health services. Assists the Director of Behavioral Health in community outreach efforts to increase awareness and utilization of services. Represents the Behavioral Health department on internal committees, such as the Compliance/Risk Committee, Safety Committee, and Quality Assurance/Quality Improvement (QA/QI) Committee. Administrative & Operational Support: Provides general administrative support to the Director of Behavioral Health, including assistance with travel arrangements, training logistics, and expense reimbursements. Demonstrates adaptability and serves as a change agent to support ongoing departmental and organizational improvements. Supports teamwork and proactive communication among the Behavioral Health team and across departments. Intermittent Duties: Performs other duties as assigned by the Director of Behavioral Health to support departmental operations and organizational needs. Off-Site Work: Occasional off-site work is required for this position. With prior Team Leader approval, various job tasks may be completed remotely. These may include, but are not limited to: program development, policy and procedure updates, conference calls, grant writing, and similar administrative tasks. Employees approved for off-site work must have a confidential, designated workspace to ensure privacy and productivity. Off-site work classification and arrangements will be reviewed by the Team Leader at hire, during annual performance evaluations, and as needed throughout the year. Skills/Qualifications: Education & Experience: Some college coursework with 2-4 years of experience in a social or human services-related field, preferably with direct behavioral health experience. Bachelor's degree in a related field preferred. Specialized training or certifications (e.g., Non-Violent Crisis Intervention, Suicide Prevention/Intervention) are preferred. Technical & Professional Skills: Proficient in Microsoft Office Suite (Word, Excel, PowerPoint); ability to learn additional software and systems as needed. Strong organizational and time management skills, with the ability to prioritize tasks, meet deadlines, and manage multiple responsibilities. High-level problem-solving skills and sound judgment, with the ability to make independent decisions and consult with leadership when appropriate. Communication & Interpersonal Skills: Excellent verbal and written communication skills. Demonstrated cultural competency and the ability to engage effectively with individuals from diverse backgrounds. Strong interpersonal skills and a professional, customer-service-oriented demeanor. Other Key Competencies: Ability to take initiative and follow through on assignments with minimal supervision. Flexible, adaptable, and able to function effectively in a fast-paced, team-oriented environment. Personal Attributes: The Behavioral Health Services Manager must maintain strict confidentiality and consistently uphold HOPE's core values while performing all duties. The ideal candidate will demonstrate the following personal qualities: Trustworthiness and integrity Respectfulness toward patients, colleagues, and the community Cultural awareness and sensitivity to diverse backgrounds Flexibility and adaptability in a dynamic work environment Strong work ethic and commitment to excellence Working Conditions & Physical Demands: This position primarily functions in a professional office environment with periodic travel between HOPE sites. Occasional extended hours may be required based on organizational priorities. As a healthcare setting, employees may be exposed to body fluids and other potential health hazards. Requires sufficient visual acuity to read, write, and operate equipment commonly used in this role. Must be able to communicate effectively in English, both verbally and in writing; proficiency in a second language is helpful but not required. Requires adequate hearing ability to communicate effectively in person and by telephone. Occasionally required to lift items weighing up to 25 pounds. Note: This is intended to convey information essential to understanding the scope of the Behavioral Health Services Manager. It is not intended to be an exhaustive list of qualifications, duties, or responsibilities, as other duties may be assigned as needed. This job description follows the Americans with Disabilities Act (ADA) and the Fair Labor Standards Act (FLSA) (May 1995) HOPE Family Health Services is an equal opportunity employer who complies with applicable State and Federal civil rights laws and does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, veteran or disability status. Many positions at HOPE Family Health Services are funded in-part or in-whole by State or Federal Department of Health and Human Services funding and as such, our organization cannot employ individuals with certain criminal backgrounds or who are on State or Federal exclusion or debarment lists.

Join our award winning culture as we serve members in your area! The Care Manager (CM), as part of an interdisciplinary team (IDT) with a RN Care Manager (RN CM), serves Lakeland Care's (LCI) members, the frail elderly, adults with physical disabilities, and adults with intellectual/developmental disabilities. The Care Manager provides care management and service coordination to LCI members. The Care Manager arranges for provision of services and supports based on a comprehensive assessment of the member's identified outcomes and needs. The IDT monitors the provision of services based on the member-centered plan per LCI policy and procedures, and Department of Health Services (DHS) contract requirements. Position requires traveling in the field/community visiting members. Responsibilities & Competencies: Coordinate and participate in home visits and care conferences involving the member, their supports, and providers. Collaborate with RNCM to coordinate acute and primary care services, care transitions, and related follow-up care. Conduct in-person comprehensive, strengths-based assessment of the member's outcomes, needs and risks; perform reassessment as condition changes. Develop, coordinate, monitor and evaluate the members' outcome-based member-centered plans, considering cost and effectiveness in authorizing services and choosing providers. Implement risk mitigation strategies to promote the member's health, safety and independence while respecting the member's rights to appeal and grieve. Maintain member records as required by DHS contract and LCI policy. Build and maintain an effective and collaborative working relationship with RNCM partner and various departments/stakeholders. Participate in team meetings and on-going trainings to stay abreast of policies, procedures, and state/federal regulations. Maintain the confidentiality of member information and protected health information (PHI) in accordance with HIPAA and state/federal regulations. Requirements Certified Social Worker in the State of Wisconsin with a minimum of one (1) year experience working with at least one of the family care target populations, OR A four-year bachelor's degree or more advanced degree in Human Services or related field with one (1) year experience working with at least one of the family care target populations, OR A four-year bachelor's degree or more advanced degree in any other area than Human Services with a minimum of three (3) years' experience working with at least one of the family care target populations. Working knowledge of computers, computer programs, typing, and data entry. Ability to access members' homes which are not required to comply with the ADA regulations. Ability to multi-task and work in a fast-paced environment. Ability to lift up to 25lbs. Current driver's license, acceptable driving record and proof of adequate insurance. --------------------------------------------------------------------------------------------------- Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible elders and individuals with physical and intellectual or developmental disabilities. Currently we serve members in 22 counties and have 11 offices throughout the Central to North East region of Wisconsin. Our Mission Empowering individuals. Strengthening communities. Inspiring futures. Our Vision To create a world we all want to live in. Our Core Values Kindness - We believe kindness is always possible and that no compassionate act is ever wasted. Inclusion - We believe that open hearts and open minds are the only path to a brighter future. Trust - We believe that honesty is still in style and that promises still have power. We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. We are an organization that participates in E-Verify.

Join our award winning culture as we serve members in your area! Out of our Wausau office serving members in and around Stevens Point, WI Rapids and Marshfield . The Care Manager (CM), as part of an interdisciplinary team (IDT) with a RN Care Manager (RN CM), serves Lakeland Care's (LCI) members, the frail elderly, adults with physical disabilities, and adults with intellectual/developmental disabilities. The Care Manager provides care management and service coordination to LCI members. The Care Manager arranges for provision of services and supports based on a comprehensive assessment of the member's identified outcomes and needs. The IDT monitors the provision of services based on the member-centered plan per LCI policy and procedures, and Department of Health Services (DHS) contract requirements. Position requires traveling in the field/community visiting members. Responsibilities & Competencies: Coordinate and participate in home visits and care conferences involving the member, their supports, and providers. Collaborate with RNCM to coordinate acute and primary care services, care transitions, and related follow-up care. Conduct in-person comprehensive, strengths-based assessment of the member's outcomes, needs and risks; perform reassessment as condition changes. Develop, coordinate, monitor and evaluate the members' outcome-based member-centered plans, considering cost and effectiveness in authorizing services and choosing providers. Implement risk mitigation strategies to promote the member's health, safety and independence while respecting the member's rights to appeal and grieve. Maintain member records as required by DHS contract and LCI policy. Build and maintain an effective and collaborative working relationship with RNCM partner and various departments/stakeholders. Participate in team meetings and on-going trainings to stay abreast of policies, procedures, and state/federal regulations. Maintain the confidentiality of member information and protected health information (PHI) in accordance with HIPAA and state/federal regulations. Requirements Certified Social Worker in the State of Wisconsin with a minimum of one (1) year experience working with at least one of the family care target populations, OR A four-year bachelor's degree or more advanced degree in Human Services or related field with one (1) year experience working with at least one of the family care target populations, OR A four-year bachelor's degree or more advanced degree in any other area than Human Services with a minimum of three (3) years' experience working with at least one of the family care target populations. Working knowledge of computers, computer programs, typing, and data entry. Ability to access members' homes which are not required to comply with the ADA regulations. Ability to multi-task and work in a fast-paced environment. Ability to lift up to 25lbs. Current driver's license, acceptable driving record and proof of adequate insurance. --------------------------------------------------------------------------------------------------- Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible elders and individuals with physical and intellectual or developmental disabilities. Currently we serve members in 22 counties and have 11 offices throughout the Central to North East region of Wisconsin. Our Mission Empowering individuals. Strengthening communities. Inspiring futures. Our Vision To create a world we all want to live in. Our Core Values Kindness - We believe kindness is always possible and that no compassionate act is ever wasted. Inclusion - We believe that open hearts and open minds are the only path to a brighter future. Trust - We believe that honesty is still in style and that promises still have power. We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. We are an organization that participates in E-Verify.

***This role is for the shift Mon/Tues/Wed (8:30am-5:00pm or 12:30pm-9:00pm) and Thurs/Fri 12:30pm-9:00pm PST*** Welcome to Pine Park Health! About Us Pine Park Health is a value-based primary care practice that is redesigning how residents of senior living communities get or stay healthy and lead a life they love. We're on a mission to dramatically improve healthcare for seniors by building a new model of care that's designed around everyone involved - patients, families, community staff members, providers, and payers. We've started by providing regular prevention and screening, care for chronic conditions, lab work, and diagnostic testing to patients in their apartments. We visit each community frequently to see patients and collaborate on patient health needs with staff. We also make it easier for patients to get care urgently with same-day or next-day care, helping them avoid unnecessary trips to the ER or hospital. Over 185 communities across Arizona, California, and Nevada work with Pine Park Health today and we're growing quickly to expand our reach and impact. Investors include First Round Capital, Google's AI fund, Canvas Ventures, Foundation Capital, Y Combinator, and Susa. If you're a determined and mission-oriented person who is looking to build the future of healthcare for seniors, join us! The Opportunity The Primary Care Coordinator serves as the central point of contact for our primary care geriatric care team, managing 500-600 patients alongside nurses and Primary Care Providers. The role focuses on coordinating patient care, maintaining relationships with senior living facilities, and ensuring excellent healthcare delivery through effective communication and documentation. ***This role is for the shift Mon/Tues/Wed (8:30am-5:00pm or 12:30pm-9:00pm) and Thurs/Fri 12:30pm-9:00pm PST*** Key Responsibilities: - Serve as primary contact for patients, families, and providers - Schedule and coordinate medical appointments - Manage patient documentation and EMR updates - Process urgent care calls and STAT tasks - Participate in mandatory after-hours shift rotation - Handle communications via phone, email, text, and fax - Coordinate with community partners and specialty providers - Facilitate new patient onboarding Key Evaluation Metrics: Success will be measured in the following focus areas: Inbound Phone Calls: -Answer 95% of inbound calls within 60 seconds and expect ~30 inbound calls / day -Aim for an average wait time of less than 30 seconds -Ensure caller wait times do not exceed 2 minutes Task Completion: -Messages and Clinical Emails: Address 95% within 2 hours -Complete routine tasks within 7 days; STAT tasks completed within 24 hours -Proactively contact all newly enrolled patients within 24 hours to schedule a welcome visit -Complete 100% of visit reminder calls each day and expect to make ~20 reminder calls / day Voicemails: -Close/resolve all urgent voicemails within 1 hour -Return non-urgent voicemails within 1 business day -Ensure after-hours voicemails are addressed within first 2 hours of next business day Patient Care Management: -Ensure accurate logging of all patient encounters for chronic care management -Log 6 hours per day of care coordination using our custom logging software -Assist with improvement projects related to quality and efficiency -Achieve a patient satisfaction survey score of 8.5/10 or higher Requirements: - Shift hours M-F 12:30am-9:00pm PST - High School Diploma (some college preferred) - Basic understanding of Primary Care Operations - Medical Assistant Certification preferred - Reliable internet and HIPAA-compliant workspace - Comfort with healthcare technology platforms - Ability to thrive in a fast-paced, changing environment - Attendance is critical in this role to ensure quality patient care - Must be able to work ~5 on call overnights and/or weekends - Ongoing Regulatory Requirement: Must not be on any exclusion or debarment from participation in Federal Health Care Programs at any time and must remain in good standing with government regulators such as the OIG, CMS, etc. Benefits Designed For You and Yours Stock Option Plan Paid Parental Leave Medical, Vision, and Dental Insurance 401K Retirement Plan Mileage and Cell Phone Reimbursement Annual Wellness Allowance Professional and Personal Development Annual Allowance FSA and Dependent Care FSA 10 Paid Holidays Paid Time Off Paid Sick days Physical Requirements: - Ability to remain seated for extended periods - High proficiency with computers and mobile devices This is not necessarily an all-inclusive list of job-related responsibilities, duties, skills, efforts, requirements, or working conditions. While this is intended to be an accurate reflection of the current job, the Company reserves the right to revise the job or to require that other or different tasks be performed as assigned. All job requirements are subject to possible revision to reflect changes in the position requirements or to reasonably accommodate individuals with disabilities. This job description in no way states or implies that these are the only duties to which will be required in this position, employees may be required to follow other job-related duties as requested by their supervisor/manager (within guidelines and compliance with Federal and State Laws). Continued employment remains on an “at-will” basis.

LOCATION: Remote - must live in or near Rowan 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.

LOCATION: Remote - must live in or near Rowan County, North Carolina. The person in this position is required to 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 Licensed Professional (“Care Manager - LP”) 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 - LP works with the member and care team to identify and 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 Manager - LP supports and may provide clinical 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 - LP also works with other Vaya staff, members, relatives, caregivers/ natural supports, providers, and community stakeholders. The Care Manager - LP also utilizes licensed clinical knowledge and skills to assess needs, inform care planning development, provide clinical consultation, and offer recommendations for appropriate care. As further described below, essential job functions of the Care Manager - LP includes, 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 (Health Insurance Portability and Accountability) 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 (North Carolina) 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 Clinical 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. Administers the PHQ-9, GAD, CRAFT, ACES, LOCUS/CALOCUS, and other screenings based on member's needs. The Care Manager - LP 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 uses clinical skills to evaluate and incorporate other available clinical information into the assessment as necessary Work with members to identify barriers and help resolve dissatisfaction with services or community-based interventions Uses clinical skills and expertise to review clinical assessments conducted by providers to ensure all areas of the member's needs are addressed. Care Manager - LP reviews for clinical accuracy and may provide consultation and technical support to providers as needed based on reviews. Interprets and analyzes clinical assessments to draw clinical conclusions to support care management activities. Engages with provider clinical staff to determine clinical appropriateness and course of action when assessments present a wide array of treatment options and members present with complex needs. Helps 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 and pharmacist along with the member to address needs and goals in the most effective way ensuring that member/LRP could 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 consult with clinical staff as needed to ensure all areas of the member's needs are addressed Provide clinical assessment in situations where the member's lack of clinical home or available network provider creates significant risk to member well-being (e.g., need for time sensitive placement/ discharge from inpatient setting) 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 Ensures the crisis plan includes problem definition, physical/cognitive limitations, health risks/concerns, medication alerts, baseline functioning, signs/symptoms of crisis (triggers), de-escalation techniques. 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: Utilizes advanced knowledge in their work which requires use of their advanced degree and licensure to be able to participate and initiate independent decisions with matters of significance and drive positive clinical outcomes for Vaya members. Executes independent discretion and engages in business decisions for the Vaya Care Management Department that support initiatives to promote Vaya's integrated, whole-person care model for members. 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. Participates 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. Ensures 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. Participates in Vaya committees, workgroups, and other efforts that require clinical knowledge, as requested, and identified. 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) Exceptional 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 Strong attention to detail and superior 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 Must be highly skilled at shifting between macro and micro level planning, maintaining both the big picture, and seeing that the details are covered. Ability to use higher-level clinical training and licensure to perform clinical assessments, drive positive outcomes for members, support care management colleagues, and offer clinical assistance to providers. Highly skilled at performing clinical assessments of members and identifying member needs. Extensive 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 Master's degree in a field related to health, psychology, sociology, social work, nursing or another relevant human services area. For incumbents with a Master's Degree in a Human Services Area besides Nursing, one of the following required years of experience: 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-tern Services and Supports and/or Home Community Based Services 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 For incumbents with a Master's Degree in Nursing, four years of full-time accumulated experience in mental health with the population served is required. Experience can be before or after obtaining RN licensure. *Must meet the criteria of being a North Carolina Qualified Professional with the population served in 10A NCAC 27G .0104 Licensure/Certification Required: Valid licensure required. Acceptable license for incumbents with a Master's Degree in nursing is Registered Nurse (RN). Acceptable licenses for incumbents with a Master's Degree in a field related to health, psychology, sociology, social work, or another relevant human services field include Licensed Clinical Social Worker (LCSW), Licensed Clinical Social Worker Associate (LCSWA), Licensed Clinical Mental Health Counselor (LCMHC), Licensed Clinical Mental Health Counselor Associate (LCMHCA), Licensed Clinical Mental Health Counselor Supervisor (LCMHCS), Licensed Psychological Associate (LPA), Health Services Professional Psychological Associate (HSP-PA), Licensed Clinical Addiction Specialist (LCAS), Licensed Clinical Addiction Specialist Associate (LCASA), Licensed Marriage and Family Therapist (LMFT) or Licensed Marriage Family Therapist Associate (LMFTA). *Due to the multi-disciplinary nature of the LME/MCO business, care managers must operate within their scope of practice, and must engage and leverage other disciplines outside of their own training and credentials. 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 exempt and is not 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.

OCATION: Remote - must live in or near Haywood 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.

Our Mission is to provide compassionate care and services to empower individuals experiencing substance use disorders, mental illnesses, and homelessness to attain an enhanced quality of life regardless of ability to pay.? Position Profile: Our Care Coordinator works directly with people in both our Medically Monitored Withdrawal Unit (MMWU) and Residential Treatment Program located at 10 Andover Road to assist them in coordinating aftercare plans and connect to needed resources for their recovery. They will assist clients in connecting to needed area resources and support them in their continued recovery. This work may also involve families and friends of clients. The Care Coordinator also works with service providers to engage resources and achieve coordination of care for a client. Care Coordinators do not focus on clinical work, but they must still be capable of responding in professional and ethical ways including cultural responsiveness and trauma-informed best practices. Essential Functions and Responsibilities: Identifies areas of need by reviewing biopsychosocial assessments completed by either MMWU or RTP team and collaborates with these team members. Assists clients in accessing needed services to support clients' treatment and community integration efforts and plans. Links to and provides support with other services (vocational, educational, social/recreational, transportation, etc.) and advocates for entitlements such as MaineCare. Facilitates ongoing collaboration and communication between providers. Integrates clients' supports (family, social, community) to help remove barriers for clients. Completes necessary administrative tasks according to deadlines. Attends staff meetings and development training as scheduled. Participates in clinical supervision including QA review of documentation and personal goal tracking highlighted in yearly evaluation. Completes all authorizations for services and continued stay reviews. Transport clients as necessary. Adheres to agency policies and procedures. Completes and maintains necessary records and reports in an accurate and confidential manner. Performs other duties as assigned. Work Location and Schedule: This position is based at 10 Andover Rd in Portland, Maine. This is a 40 hour per week, hourly position with a schedule of Monday through Friday 8:30am-4:30pm. Compensation: Compensation for this position ranges from $20.50 - $24.00 per hour, based on experience and credentials. Requirements Qualifications: Valid driver's license and reliable transportation is required. Associate's degree in social services or related field preferred. 1 year of successful community-based mental health/substance abuse work is a plus.?Must be MHRT-C certified or provisional eligible. Recovery Coach training is preferred. Salary Description $21 - $24 per hour