Tailored Care Management Extender

Tailored Care Management (TCM) Extender

The Tailored Care Management (TCM) Extender supports the delivery of Tailored Care Management services under North Carolina’s Medicaid program, including services aligned with the North Carolina Department of Health and Human Services(NCDHHS) and NC Medicaidguidelines.

The TCM Extender works under the supervision of a qualified Tailored Care Manager to assist members enrolled in NC Medicaid Tailored Plans, including individuals with complex behavioral health needs, intellectual/developmental disabilities (I/DD), traumatic brain injury (TBI), and/or significant physical health conditions.

This role focuses on care coordination support, member engagement, resource linkage, documentation assistance, and follow-up activities to ensure members receive comprehensive, whole-person care

Essential Duties and Responsibilities

Care Coordination Support

• Assist Tailored Care Managers with outreach and engagement of assigned members.

• Conduct follow-up calls, appointment reminders, and wellness checks.

• Support scheduling of medical, behavioral health, and social service appointments.

• Help coordinate care across physical health, behavioral health, pharmacy, and community-based services.

Member Engagement

• Provide education to members and families regarding services, benefits, and available community resources.

• Support implementation of Person-Centered Care Plans.

• Assist members in accessing transportation, housing resources, food assistance, and other social determinants of health supports.

Documentation & Compliance

• Document member interactions accurately and timely in the electronic health record (EHR) system.

• Maintain compliance with Medicaid, HIPAA, and organizational policies.

• Support data collection for quality measures and reporting requirements.

Tailored Care Management (TCM) Extender

The Tailored Care Management (TCM) Extender supports the delivery of Tailored Care Management services under North Carolina’s Medicaid program, including services aligned with the North Carolina Department of Health and Human Services(NCDHHS) and NC Medicaidguidelines.

The TCM Extender works under the supervision of a qualified Tailored Care Manager to assist members enrolled in NC Medicaid Tailored Plans, including individuals with complex behavioral health needs, intellectual/developmental disabilities (I/DD), traumatic brain injury (TBI), and/or significant physical health conditions.

This role focuses on care coordination support, member engagement, resource linkage, documentation assistance, and follow-up activities to ensure members receive comprehensive, whole-person care

Essential Duties and Responsibilities

Care Coordination Support

• Assist Tailored Care Managers with outreach and engagement of assigned members.

• Conduct follow-up calls, appointment reminders, and wellness checks.

• Support scheduling of medical, behavioral health, and social service appointments.

• Help coordinate care across physical health, behavioral health, pharmacy, and community-based services.

Member Engagement

• Provide education to members and families regarding services, benefits, and available community resources.

• Support implementation of Person-Centered Care Plans.

• Assist members in accessing transportation, housing resources, food assistance, and other social determinants of health supports.

Documentation & Compliance

• Document member interactions accurately and timely in the electronic health record (EHR) system.

• Maintain compliance with Medicaid, HIPAA, and organizational policies.

• Support data collection for quality measures and reporting requirements.

Community Collaboration

• Communicate with providers, community agencies, and care team members as directed by the Tailored Care Manager.

• Participate in case reviews, team meetings, and care coordination discussions.

Preferred Qualifications

Care manager extenders must have the following qualifications:

• At least 18 years of age, and

• A high school diploma or equivalent (e.g., GED, certificate of completion), and

• Meet one of the following requirements:

o Be a person with lived experience with an I/DD or a TBI with demonstrated knowledge of and direct personal experience navigating the NC Medicaid delivery system

or

o Be a person with lived experience with a behavioral health condition who is a Certified Peer Support Specialist

or

o A parent or guardian of an individual with an I/DD, TBI or a behavioral health condition and who has at least two years of direct experience providing care for and navigating the Medicaid delivery system on behalf of that individual (note that a parent/guardian cannot serve as an extender for his/her own family member).

or

o Has two years of paid experience performing the types of functions described in the Extender Functions section below, with at least one year of paid experience working directly with the TCM eligible population.

… extenders cannot work for the same organization where they receive services. The Department expects that a range of individuals meet these qualifications, including, but not limited to:

• Certified Peer Support Specialists

• Community health workers (CHW), defined as individuals who have completed the North Carolina Community Health Worker Association | CHW Training and Resources

• Individuals who served as Community Navigators prior to the implementation of Tailored Plans

• Family navigators, as defined by Trillium Health Resources’approved In-Lieu of service description

• Parents or guardians of an individual with an I/DD or a TBI or a behavioral health condition (parent/guardian cannot serve as an extender for his/her own family member)

• A person with lived experience with an I/DD or a TBI or a behavioral health conditionCommunity Collaboration

• Communicate with providers, community agencies, and care team members as directed by the Tailored Care Manager.

• Participate in case reviews, team meetings, and care coordination discussions.

Preferred Qualifications

Care manager extenders must have the following qualifications:

• At least 18 years of age, and

• A high school diploma or equivalent (e.g., GED, certificate of completion), and

• Meet one of the following requirements:

o Be a person with lived experience with an I/DD or a TBI with demonstrated knowledge of and direct personal experience navigating the NC Medicaid delivery system

or

o Be a person with lived experience with a behavioral health condition who is a Certified Peer Support Specialist

or

o A parent or guardian of an individual with an I/DD, TBI or a behavioral health condition and who has at least two years of direct experience providing care for and navigating the Medicaid delivery system on behalf of that individual (note that a parent/guardian cannot serve as an extender for his/her own family member).

or

o Has two years of paid experience performing the types of functions described in the Extender Functions section below, with at least one year of paid experience working directly with the TCM eligible population.

… extenders cannot work for the same organization where they receive services. The Department expects that a range of individuals meet these qualifications, including, but not limited to:

• Certified Peer Support Specialists

• Community health workers (CHW), defined as individuals who have completed the North Carolina Community Health Worker Association | CHW Training and Resources

• Individuals who served as Community Navigators prior to the implementation of Tailored Plans

• Family navigators, as defined by Trillium Health Resources’approved In-Lieu of service description

• Parents or guardians of an individual with an I/DD or a TBI or a behavioral health condition (parent/guardian cannot serve as an extender for his/her own family member)

• A person with lived experience with an I/DD or a TBI or a behavioral health condition

Job Type: Full-time

Pay: $31,200.00 - $43,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Travel reimbursement

Work Location: Hybrid remote in Statesville, NC 28625

Salary : $31,200 - $43,000