Case Manager

Overview

• Coordinate care and resources for members to achieve optimal clinical and resource outcomes in a multidisciplinary team environment.
• Perform comprehensive assessments to collaborate with members, families, and providers on tailored treatment plans and interventions.
• Develop member-centric care plans addressing health, education, and support needs while identifying barriers to achieving goals.
• Utilize community resources and funding sources to enhance care plans and member support.
• Monitor and manage member progress through scheduled follow-ups, referrals, and plan modifications as needed.
• Evaluate care provided across the continuum, including physician offices, hospitals, and home care settings.
• Educate members to encourage proactive interventions, reducing expenses and promoting positive outcomes.
• Document all aspects of care plans, including assessments, implementation, monitoring, and evaluations.

Key Responsibilities & Duties

• Coordinate care and resources for members to achieve optimal outcomes within a multidisciplinary team.
• Perform comprehensive assessments to develop tailored treatment plans and interventions for members.
• Develop care plans addressing health, education, and support needs while identifying barriers to success.
• Utilize community resources and funding sources to enhance care plans and member support.
• Monitor and manage member progress through scheduled follow-ups, referrals, and plan modifications as needed.
• Evaluate care provided across the continuum, including physician offices, hospitals, and home care settings.
• Educate members to encourage proactive interventions, reducing expenses and promoting positive outcomes.
• Document all aspects of care plans, including assessments, implementation, monitoring, and evaluations.

Job Requirements

• Bachelor of Science in Nursing (BSN) is required for this position.
• Minimum of 3 years of clinical or case management experience; 5 years preferred.
• Valid and applicable clinical license (NC or compact multi-state licensure) is mandatory.
• Additional specialty certification (e.g., CCM, CDCES) may be required within 2 years of employment.
• Experience in behavioral health roles with applicable licensure is considered.
• Strong documentation skills to record assessments, plans, and outcomes effectively.
• Ability to utilize community resources and funding sources to support care plans.
• Proficiency in developing and implementing member-centric care plans tailored to individual needs.