Clinical Risk Manager Jobs in Boydton, VA (NOW HIRING)

Currently hiring and must reside in the following NC counties: Granville County and neighboring counties

This is a field-based position with working remotely, when not providing integrated services to members directly. Occasional in-person training and travel will be required.

From the mountains to the coast, from large cities to small towns, Community Care of North Carolina is transforming health care. Informed by statewide data and predictive analytics, community-based care-managers work with local physicians and diverse teams of health professionals to develop whole-person plans of care that connect people to the right local resources and increase equity and access to high quality care.

To improve the health and quality of life for all North Carolinians by building supporting better community-based healthcare delivery systems.

Our new program, the Care Manager 1 - Non-Clinical, will provide statewide care management to support Medicaid enrolled members receiving adoption assistance. Care Managers address the needs of the population served by assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required so they receive seamless, integrated, and coordinated health care to promote quality, cost-effective health outcomes.

Collaboration with the Primary Care Provider, member, guardian, caregivers, family members, other members of the Care Management Team, and the community is necessary to coordinate a full continuum of health care services. Holistic needs of the member, inclusive of unique social and cultural dynamics should be considered. The Care Manager must reside in NC or within 40 miles of the NC Border.

• Provide integrated whole-person Care Management under the new program Care Management model, including coordination across physical health, behavioral health, I/DD, LTSS, pharmacy, and unmet health-related needs.
• Complete member assessments considering the total individual, inclusive of medical, biopsychosocial, behavioral, spiritual, and cultural needs to enrolled population, throughout the continuum of care
• Work with members and caregivers to identify and address behavioral, social, cultural, and environmental strengths and barriers as it relates to his/her diagnosis, treatment, and access to care
• Provide education to member/family about clinical diagnosis, medications, available resources, prevention, and risk factors to achieve optimal self-management
• Monitor quality and effectiveness of interventions to the enrolled populations by setting patient-centered SMART goals in collaboration with the members/families
• Develop, review, implement, and evaluate the member care plan in partnership with the member, caregiver/guardian/family members, providers, and Care Management team members, as applicable
• Incorporate therapeutic skills and techniques such as trauma-informed care, motivational interviewing, strengths-based, and solution-focused modalities to help members achieve healing, growth, health, and wellness
• Utilize Hospital/Data or Electronic Medical Record system as available
• Per guidance, facilitate referrals for members/families to appropriate community-based services and agencies
• Refer to appropriate clinical team members for interventions which are outside the Care Managers’ scope of practice and/or expertise
• Work collaboratively with multi-disciplinary team members to facilitate achievement of desired treatment outcomes
• Engage and maintain collaborative relationships with community provider agencies that promote quality care and cost-effective health care utilization
• Serve as a liaison among the member/family/guardian, community services, primary providers, specialists, and other care team members to coordinate services without duplication
• Respect the member’s values, experience, and help to empower members to be an advocate for their own care
• Maintain appropriate documentation in the Care Management documentation platform, in accordance with organizational policies and procedures
• Meet monthly productivity and role expectations
• Understand, uphold, and abide by CCNC company and department policies, goals, standards, and objectives
• Adhere to CCNC privacy, security policies, and HIPAA regulations to ensure that patient and company data are properly safeguarded
• Perform all other duties as requested
• Attend departmental and corporate meetings, local and regional trainings, or other events as required
• Travel using personal vehicle will be required within the assigned area, region and/or the State

• Requires a Bachelor's Degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services area or licensure as an RN
• 2 years of experience working directly with individuals served by the child welfare system is preferred
• Must reside in NC or within forty (40) miles of the NC Border
• CCM certification preferred
• Maintain a valid driver’s license with current auto liability insurance

• Computer skills required including various office software and the internet, including experience with MS Office software.
• Excellent communication skills – oral and written; Bilingual preferred
• Knowledge of government, private sector, and community resources
• Knowledge of Case Management principles
• Knowledge of, and compliance with, federal and state regulations applicable to the position
• Strong organizational and time management skills
• Skills in establishing rapport with members and caregivers and applying techniques of assessing comprehensive health care needs
• Critical thinking skills, effective clinical judgment, independent decision-making, and problem-solving abilities
• Sensitivity to diversity of cultures, language barriers, health literacy, and educational levels
• Ability to work independently and function as an integral part of a multi-disciplinary team
• Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives
• Ability to shift strategy or approach in response to the demands of a situation
• Ability to navigate Hospital/Data or Electronic Medical Record systems, as necessary

• This is a field position. Care Manager will work remotely from home when not in the field
• Multiple contacts, face to face and/or telephonic, are required with various members, providers, multi-payer systems and community partners to ensure coordination of services; exposure to general office and household conditions, as well as communicable disease could occur
• Routinely there may be some minor physical inconveniences or discomforts in the work setting, including sitting for moderate periods of time
• Must be able to utilize office equipment, computer, keyboard, and phone with or without assistive devices
• Repetitive wrist motion and occasional lifting/carrying of up to 25 pounds
• Travel will be required within the assigned area or region with occasional travel in other areas of the State

• Make a meaningful impact on youth and families across North Carolina
• Work with a supportive and collaborative care team
• Competitive Benefits Package effective first day of employment
• Opportunities for growth, training, and bonus incentives*

Ready to improve the health and quality of life of all North Carolinians by building and supporting better community-based health care delivery systems?

Ready to improve the health and quality of life of all North Carolinians by building and supporting better community-based health care delivery systems?

Apply today and join us in delivering compassionate care that makes a difference.

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