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Role Description

This position is responsible for providing proactive intervention and care management consultation and support to promote high quality, whole person care for individuals with behavioral health (BH), intellectual/developmental disabilities (IDD), and/or traumatic brain injury (TBI) with or at risk for physical health complexities. The focus of this position is to ensure that individuals receive appropriate collaborative care assessment and services. This is a mobile position with work done in a variety of locations. Travel is an essential function of this position.

Responsibilities

• Provides physical health expertise and consultation
• Serves as the point of contact regarding collaborative care for care management teams
• Uses available data and medical information to provide proactive consultation and advice to the dedicated care managers regarding action steps needed to promote and/or improve member health
• Provides direct care management support as needed (informing, educating, linking, phone communication with member or collaterals, participation in care team meetings)
• Participates in clinical huddles/rounds with care managers, clinical and medical leadership
• Takes lead on scheduling, presenting and providing updates in clinical huddles when indicated
• Facilitates medication reconciliation
• Assists department leadership in staff training and development, supporting care managers in development of necessary skills and resources to improve member health status
• Provides guidance to care management staff on using Healthwise topics for health education and promotion with members
• Measures results of intervention and treatment, including reduction in high risk events and inappropriate service utilization
• Assists in quality of care monitoring through review of care plans, medical records, critical incident reports and other sources of information and provides consultation on quality of medical care or recommends areas for quality improvement
• Analyzes medical, psychiatric, behavioral health diagnosis and medication data reports to identify potential contraindications in treatment on a scheduled basis
• Participates actively in learning collaborative with other Care Management nurses
• Will serve as tailored care manager for an identified high cost/high risk population and complete all needed assessments and reviews for care management
• Will participate and complete other duties as assigned

Qualifications

• Ability to provide consultative supports for physical health diagnosis and treatment to include education, assessment, and care planning for whole person care
• Understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version)
• Considerable knowledge of the IDD/TBI/MH/SUD service array provided through the network of the LME/MCO’s Providers
• Knowledge of NC Medicaid, Managed Care, NC Innovations Waiver, 1915i option, LTSS, Tailored Plan and Standard Plans
• Ability to analyze data and use data to drive decision-making
• Ability to provide effective and clinically sound consultation/education/training to others
• Ability to establish and maintain positive and effective working relationships with others both within the agency and community
• Exceptional interpersonal and communication skills
• Excellent computer skills including proficiency in Microsoft Office products (Word, Excel, Outlook, and PowerPoint)
• Excellent problem solving, negotiation, arbitration, and conflict resolution skills
• Detail-oriented, able to organize multiple tasks and priorities and effectively manage projects from start to finish
• Ability to make prompt independent decisions based upon relevant facts, to establish rapport and maintain effective working relationships
• Ability to change the focus of his/her activities to meet changing priorities

Requirements

• Licensed to practice as a Registered Nurse in North Carolina and two years of experience in intellectual and developmental disabilities, traumatic brain injury, and/or behavioral health
• Must reside in North Carolina
• Must have ability to travel regularly as needed to perform job duties

Preferred Experience

• Licensed to practice as a Registered Nurse in North Carolina and two years of experience in psychiatric nursing with dually diagnosed MH/IDD; care management/care coordination experience
• Experience in collaborative care
• Fluency in written and verbal bi-lingual Spanish/English language expertise

Licensure/Certification Requirements

• Must be licensed as a Registered Nurse in North Carolina
• Employee is responsible for complying with respective licensure board’s continuing education/training requirements in order to maintain an active license

Benefits

• Competitive Compensation & Benefits Package
• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
• Public Service Loan Forgiveness Qualifying Employer