Case Management Care Navigator

ResCare Community Living, a part of the Sevita family, provides quality services that empower individuals, enhance independence, and help people live well. Since 1974, we’ve supported individuals with intellectual and developmental disabilities to live more independently at home and in their community. With our dedicated team and experienced staff, we provide person-centered services that help people build skills, overcome challenges, and reach their full potential.

Summary

Work in conjunction with the Care Manager to deliver to deliver integrated, whole-person care management addressing a member’s physical health, behavioral health, intellectual/developmental disability (I/DD), traumatic brain injury (TBI), long-term services and supports (LTSS), and/or pharmacy needs, in addition to unmet health- related resource needs. Provide services in accordance with care management service requirements set by the state and company.

Essential Job Functions

To perform this job successfully, an individual must be able to satisfactorily perform each essential function listed below.

• Supports Care Managers in delivering care management.
• Engages the member /family/guardian with professionalism, compassion, and purpose through telephonic and virtual methods and in-home visits as required. Interactions should be concise, respectful, in a language of his/her choice, and non-judgmental.
• Establishes a professional rapport with all team members, stakeholders, peers and supervisors.
• Initiates the first contact with the member/family/guardian to complete the preliminary questionnaire.
• Communicates with the Case Manager any information pertaining to the care and well-being of the member/family/guardian.
• Provides documentation of billable events that align with minimum contact expectations to the Care Manager.
• Maintains an accurate, up-to-date electronic information data stream on all interactions, encounters, activities, and communications with the member/family/guardian.
• Performs general outreach, engagement, and follow up with members, to encourage accomplishment of goals set in the Plan//ISP.
• Coordinates services/appointments.
• Engages in health promotion activities and knowledge sharing.
• Shares information with the Care Manager and other members of the care team on the member’s circumstances.
• Provides and tracks referrals and provides information and assistance in obtaining and maintaining community- based resources and social support services.
• Participates in case conferences and planning meetings.
• Supports the Care Manager in Identifying and addressing barriers to services, gaps in service, and unmet health- related needs proactively, expanding relationships and linkages to aid in meeting member’s needs.
• Provides services that meet national, state, and local healthcare standards at the highest level.
• Reports issues of concern, general departmental activities and staffing needs to the Care Manager.
• Completes all required training and participates in educational sessions to improve overall skills.
• Attends industry meetings, training, and functions to promote positive relationships with stakeholders.
• Participates in quality improvement and measurement activities to achieve identified targets and outcomes.
• Performs other related duties and activities as required.
  
  

Supervisory Responsibilities

• None
  
  

Minimum Knowledge And Skills Required For The Job

The requirements listed below are representative of the knowledge, skill, and/or abilities required to perform the job.

Education And Experience

• At least 18 years old
• High School Diploma or G.E.D equivalent
• Be a person with lived experience with an I/DD or a TBI with demonstrated knowledge of and direct personal experience navigating the North Carolina Medicaid delivery system; or, a parent or guardian of an individual with an I/DD or a TBI and has at least two years of direct experience providing care for and navigating the Medicaid delivery system on behalf of that individual (parent/guardian cannot serve as an extender for their family member); or, has two years of paid experience performing functions in this job description with at least one year of paid experience working directly with the Tailored Care Management eligible population.
  
  

Certificates, Licenses, And Registrations

• Must meet all agency requirements for pre-employment and those required by state
• Trained in Tailored Care Management preferred.
  
  

Other Skills And Abilities

• Ability to perform work with a high degree of quality and autonomy
  
  

Other Requirements

• Travel as needed
  
  

Physical Requirements

• Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.
  
  

Sevita is a leading provider of home and community-based specialized health care. We believe that everyone deserves to live a full, more independent life. We provide people with quality services and individualized supports that lead to growth and independence, regardless of the physical, intellectual, or behavioral challenges they face.

We’ve made this our mission for more than 50 years. And today, our 40,000 team members continue to innovate and enhance care for the 50,000 individuals we serve all over the U.S.

As an equal opportunity employer, we do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other characteristic protected by law.