Tailored Care Management- Care Manager

Tailored Care Management – Care Manager

Location: Wilson, NC
Job Type: Full-Time
Pay: $21.00–$28.00 per hour

About the Position

We are seeking a compassionate, organized, and qualified Tailored Care Manager to join our team in Wilson, North Carolina. The ideal candidate will have experience supporting individuals with behavioral health conditions, intellectual and developmental disabilities (I/DD), or traumatic brain injuries (TBI).

Tailored Care Management is a person-centered, whole-person approach to care coordination that helps members access appropriate healthcare services, behavioral health support, community resources, and other essential services. The Care Manager works collaboratively with members, families, caregivers, healthcare providers, and community organizations to promote wellness, independence, community integration, and improved quality of life.

This role requires strong communication, care coordination, advocacy, and crisis response skills, along with a commitment to delivering high-quality, individualized care in accordance with North Carolina Department of Health and Human Services (NC DHHS) requirements.

Key Responsibilities

Care Coordination and Member Support

- Provide professional care management services within the scope of NC DHHS Tailored Plan requirements.

- Coordinate and monitor services across healthcare, behavioral health, and community-based support systems.

- Connect members and caregivers with appropriate services, including peer support, respite care, self-help programs, and other community resources.

- Ensure referrals requested by members are completed promptly and responsibly.

- Educate members and families on self-advocacy, available services, and how to navigate the healthcare and social service systems.

- Provide information regarding members' rights, protections, and responsibilities, including provider changes, grievance and complaint procedures, and fair hearing processes.

- Promote wellness, preventive care, and whole-person health.

- Assist members with understanding advance directives, psychiatric advance directives when appropriate, and guardianship options or alternatives.

Family and Community Support

- Connect members and families to resources that promote employment, educational success, socialization, independent living, and community integration.

- Help members develop adaptive skills and improve their ability to access and navigate available services.

- Collaborate with families and youth to develop strategies that strengthen family support, self-determination, and self-sufficiency.

- Promote family-driven and youth-guided service delivery by identifying natural supports, social networks, and community resources.

- Support the delivery of services in the member's community and the least restrictive appropriate setting.

- For high-risk pregnant members, assess broader family needs, provide appropriate family planning guidance, and initiate discussions regarding an Infant Plan of Safe Care when applicable.

- Assist in developing and implementing individualized care plans and proactive and reactive crisis plans in collaboration with members, families, and the care team.

Crisis Response and Safety

- Provide first-responder crisis support on a 24/7/365 basis for members receiving services, as required.

- Maintain the capacity to respond face-to-face to qualifying crisis situations within two hours.

- Ensure access to members' crisis plans and coordinate appropriate responses to emerging needs.

- Collaborate with the care team to identify potential risks, establish response procedures, and promote member safety and stability.

Documentation, Supervision, and Compliance

- Work under the supervision of the Supervising Care Manager in accordance with individualized supervision plans.

- Maintain accurate documentation of care management activities, member needs, referrals, and services.

- Participate in required supervision, training, and professional development activities.

- Ensure services are delivered promptly, responsibly, and in compliance with applicable state and federal regulations.

- Complete other duties as assigned.

Member Contact Requirements

Care Managers must maintain the minimum member contact frequency based on the member's assessed acuity level.

- High Acuity: At least four care manager-to-member contacts per month, including at least one in-person contact.

- Moderate Acuity: At least three contacts per month and at least one in-person contact per quarter.

- Low Acuity: At least two contacts per month and at least two in-person contacts per year, approximately six months apart.

In-person comprehensive assessments may count toward the applicable in-person contact requirements, as permitted by program guidelines.

Required Training

Employees must maintain all training required by applicable state and federal laws and regulations. Training includes, but is not limited to:

- Behavioral Health and Intellectual/Developmental Disabilities (BH I/DD) Tailored Plan eligibility and services

- Whole-person health and identification of unmet resource needs

- Community integration

- Components of Health Home Care Management

- Health promotion

Qualifications

To be considered for this position, candidates must meet the following minimum requirements:

- Education: Bachelor's degree in health, psychology, sociology, social work, nursing, another relevant human services field, or a Registered Nurse (RN) license.

- Experience: At least two years of experience working directly with the population served:

Individuals with behavioral health conditions, if serving members with behavioral health needs; or

- Individuals with intellectual or developmental disabilities (I/DD) or traumatic brain injuries (TBI), if serving members with those needs.

- Certifications: Must maintain Nonviolent Crisis Intervention (NCI), Community First Aid/CPR, and any additional certifications required for the position.

- Professional Competencies: Strong communication, organizational, problem-solving, documentation, and care coordination skills.

- Additional Requirements: Ability to collaborate with members, families, healthcare professionals, and community service providers while maintaining professional standards and regulatory compliance.

What We're Looking For

The ideal candidate is passionate about helping individuals access the services and resources they need to achieve greater independence and well-being. They should demonstrate empathy, sound judgment, accountability, and the ability to coordinate care effectively while responding to changing member needs.

If you are committed to person-centered care and making a meaningful difference in the lives of individuals and families, we encourage you to apply!

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