Tailored Care Management Director

Job description

SUMMAY

A TCM Care Manager Director will be responsible for addressing members’ whole-person needs alongside coordinating and monitoring their Home and Community Based (HCBS) waiver services. TCM Care Manager will focus on a full range of the following needs of the consumer: physical health, I/DD, TBI, LTSS, pharmacy and unmet health-related resource needs. Services will be provided at the site of care, in the home or in the community, through face-to-face interaction between consumers, providers, and care managers. Care management will promote whole-person care, foster high functioning integrated care teams, and drive towards better health outcomes. This position requires an understanding of and experience working with individuals who are impacted by Intellectual Developmental Disabilities (I/DD) or Traumatic Brain Injury (TBI).

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following, but not limited to:

• Responsible for overseeing the TCM department as well as multiple care management teams.
• Ensuring that care teams are functioning per the service definition.
• Review caseloads for care manager under their supervision.
• Assist with setting and implementing department goals.
• Monitoring billable contacts to ensure the financial stability of the department.
• Compiling reports to show the progress of the department.
• Follow administrative procedures and effectively manages caseloads of Care Managers.
• Ensure after-hour resources are available.
• Provide coverage during the absence of a care manager(s) and supervisors due to vacation, sick leave, and staff turnovers.
• Reviewing Individual Support Plans (ISPs) and providing guidance as needed, to care managers for how to meet consumer’s needs.
• Responsible for reviewing the care management comprehensive assessment, and reassessment as needed; engaging other professionals and natural supports in the (re)assessment process.
• Review initial ISP and updates upon the following
• Ability to modify ISP with input from recipient, professionals, and natural supports in the absence of Care Manager.
• Engage other professionals and natural supports in the (re)assessment process.
• Recognize indicators of risk including health, safety, physical, medications, etc.
• Discuss findings and recommendations with care managers after (re)assessments.
• Oversee care manager extenders such as community navigators, community health workers and certified peer support specialists.
• Assist the care manager locating and coordinating sources of help so that the individual receives available natural and community supports.
• Ensure appropriate number and type of contact is made with members based on their acuity level and preferences.
• Provide appropriate interventions for assessed needs, when needed.
• Ability to research, develop, maintain, and share information with care managers on community and other resources relevant to the recipient’s needs (medical & behavioral health programs, formal/informal supports, social service, educational, employment, housing).
• Oversee care managers facilitating the recipient’s transition into services in the care plan to achieve the outcomes derived for the consumer’s goals.
• Provide training resources for care managers, as needed.
• Provide or arrange for coverage for services, consultation or referral, and treatment for emergency medical conditions, including behavioral health crisis, 24 hours per day, seven days per week, when needed.
• Ensure care managers follow-up on referrals.
• Assign NCCare360 referrals to appropriate Care Manager.
• Ensure care managers follow-up on inbound and outbound referrals.
• Attend care team meetings, as requested.
• Serve as a member on the multidisciplinary team for consumer(s), as needed depending on consumer(s) needs.
• Understand values that underlie a person-centered approach to providing service to improve the consumers functioning within the context of the consumers culture & community.
• Perform work in a range of community settings such as recipient’s home, school, library, homeless shelters, etc.
• Ensure all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency, and Medicaid requirements.
• Perform a variety of diversion activities, as needed.
• Responds to crisis situations, as needed.
• Maintains accurate and legible documentation, as required.
• Flexible and ability to adapt to any occurring changes.
• Adhere to and follow all policies and procedures of this Agency.
• Coordinate absences from work in a timely manner.
• Fulfill all other duties assigned.

EDUCATION/QUALIFICATION REQUIREMENTS

• A bachelor’s degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services area; and
• Five years of experience providing care management, case management, or care coordination to complex individuals with I/DD, TBI and mental health diagnosis;

or

• A master’s degree in a field related to health, psychology, sociology, social work (e.g., LCSW), nursing, or another relevant human services area, or licensure as an RN; and
• Three years of experience providing care management, case management, or care coordination to complex individuals with an I/DD, TBI and mental health diagnosis.

Job Type: Full-time

Pay: $85,000.00 - $120,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Education:

• Bachelor's (Required)

Experience:

• Case management: 1 year (Preferred)
• I/DD: 1 year (Preferred)
• TBI: 1 year (Preferred)
• Mental/Behavioral health: 1 year (Preferred)

License/Certification:

• Driver's License (Required)

Willingness to travel:

• 25% (Preferred)

Work Location: In person