Care Manager

Join to apply for the Care Manager role at Community Care of North Carolina .

As a Care Manager, you will address the needs of our population by assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required to promote quality, cost‑effective health outcomes. You will operate within the scope of practice of a Registered Nurse or a Licensed Clinical Social Worker, collaborating with Primary Care Providers, members, guardians, caregivers, family members, other Care Management Team members, and community resources to coordinate a full continuum of health care services. The role may be performed remotely within approved regions.

Care Managers will serve the population in Regions 1, 3, and 5. Remote work and travel across the state are required, with a preference for candidates residing in Mecklenburg, Cumberland, Iredell, or Moore Counties.

Essential Functions

• Provide effective Care Management services based on case management standards of practice to enrolled populations.
• Complete member assessments considering medical, biopsychosocial, behavioral, spiritual, and cultural needs throughout the continuum of care.
• Work with members to identify and address behavioral, social, cultural, and environmental strengths and barriers related to diagnosis, treatment, and access to care.
• Provide education about clinical diagnosis, medications, resources, prevention, and risk factors to achieve optimal self‑management.
• Monitor quality and effectiveness of interventions, setting patient‑centered SMART goals with members/families.
• Develop, review, implement, and evaluate the member care plan in partnership with members, caregivers, providers, and the Care Management team.
• Incorporate therapeutic skills such as trauma‑informed care, motivational interviewing, strengths‑based, and solution‑focused modalities.
• Utilize Hospital/Data or Electronic Medical Record systems as available.
• Facilitate referrals to appropriate community‑based services and agencies per guidance.
• Refer to appropriate clinical team members for interventions outside your scope or expertise.
• Collaborate with multidisciplinary team members to facilitate desired treatment outcomes.
• Engage and maintain collaborative relationships with community provider agencies to promote quality care and cost‑effective utilization.
• Serve as a liaison among members/families, community services, primary providers, specialists, and care team members to coordinate services without duplication.
• Respect member values, experience, and empower members to advocate for their own care.
• Maintain accurate documentation in the Care Management platform per policies and procedures.
• Meet monthly productivity and role expectations.
• Uphold CCNC company and department policies, goals, and standards.
• Adhere to CCNC privacy, security policies, and HIPAA regulations.
• Attend departmental and corporate meetings, regional training, or other required events.
• Travel using personal vehicle as required within the region or state.
• Perform all other duties as requested.

Qualifications

Registered Nurse (RN)

• Graduation from an accredited school of nursing.
• BSN preferred.
• Active, unrestricted RN license to practice in North Carolina.
• Minimum 2 years’ nursing experience; 1-year care‑management or community‑based nursing preferred.
• CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements.
• Meets licensure or educational eligibility requirements as determined by the Commission for Case Management Certification.
• Access to Hospital/Data or Electronic Medical Record system required as necessary.
• Valid driver’s license with current auto liability insurance.

Social Worker

• Master’s degree from an accredited school of social work.
• Minimum 2 years’ social work experience; 1-year case management or community‑based social work preferred.
• Active NC license as a Licensed Clinical Social Worker (LCSW).
• CCM certification preferred; will obtain within 1 year of eligibility per CCM requirements.
• Meets licensure or educational eligibility requirements as determined by the Commission for Case Management Certification.
• Access to Hospital/Data or Electronic Medical Record system required as necessary.
• Valid driver’s license with current auto liability insurance.

Knowledge, Skills, and Abilities

• Computer skills including office software and internet; experience with MS Office preferred.
• 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 applicable federal and state regulations.
• Strong organizational and time‑management skills.
• Skills in establishing rapport and assessing comprehensive health care needs.
• Critical thinking, 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 as part of a multidisciplinary team.
• Positive attitude toward change and willingness to learn new ways to accomplish work objectives.
• Ability to adjust strategy or approach in response to demands of a situation.

Working Conditions

• Office or home environment.
• Multiple face‑to‑face and/or telephonic contacts with members, providers, and community partners; exposure to general office and household conditions, including communicable diseases, may occur.
• Routine minor physical inconveniences or discomforts (sitting for moderate periods).
• Use of office equipment and computer; possible repetitive wrist motion and occasional lifting/carrying of up to 25 pounds.
• Travel required within the region and/or the state.

Seniority Level

Entry level

Employment Type

Full‑time

Job Function

Health Care Provider

Industries: Hospitals and Health Care