CAP Nurse Case Manager (RN) / FT / Buncombe & Madison Counties / Flexible Hours / $3,000 Sign On Bonus

CAP Nurse Case Manager (RN)

Join our team at RHA Health Services! If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the lives of people with intellectual, developmental disabilities, and people facing mental health, and substance use challenges, this is the role for you.

The CAP Nurse Manager works collaboratively with the CAP Social Worker, families, healthcare providers, and service providers ensuring the health, safety, and well-being of program participants. This position is responsible for conducting assessments, completing the annual multidisciplinary and Change of Status assessments, coordinating care, monitoring service delivery, and supporting the development of person-centered care plans. The RN ensures delivery of high-quality, individualized care in compliance with Medicaid guidelines and works closely with a multidisciplinary team to ensure high-quality care for participants.

Duties and Responsibilities:

• Assessment and Care Planning:
• Conduct initial pre-screening and assessments of beneficiaries and their families to evaluate medical, psychological, behavioral, financial, social, cultural, environmental, legal, vocational, educational, and other areas.
• Consult with the CAP beneficiary and primary caregiver to educate about waiver services, Medicaid, and community resources to meet the beneficiaries' needs.
• Identify needs to prevent health and safety factors to assist in maintaining community placement.
• Develop and maintain individualized, person-centered care plans (emergency and disaster planning) to ensure the health, safety, and well-being of beneficiaries.
• Update care plans at least every 12 months or when the status of the beneficiary changes.
• Ensure beneficiaries and families understand the plan of care to make informed decisions
• Service Coordination:
• Coordinate services such as personal care, waiver supplies, home modifications, and educational support in alignment with the care plan.
• Collaborate with the team to monitor service quality and ensure compliance with Medicaid and program standards.
• Arrange for additional services as needed to prevent institutionalization and support participants in their homes.
• Monitoring and Follow-Up:
• Monitor services through monthly phone calls and home visits, document observations and beneficiary progress.
• Evaluate the effectiveness of care plans and services, recommending or implementing changes as needed to achieve desired outcomes.
• Counseling and Support:
• Provide emotional support and counseling to beneficiaries and their families to strengthen their support systems.
• Assist families in navigating challenges, including long-term palliative care, behavioral issues, and medical needs.
• Documentation and Compliance:
• Assist with obtaining documentation from medical staff to confirm the need for specific CAP services.
• Maintain accurate and up-to-date records for all participants in accordance with Medicaid and program requirements.
• Ensure compliance with 10A NCAC 27G.0202 and other regulatory guidelines.
• Review and ensure proper billing codes and compliance for case management, in-home aide documentation, paid live-in caregiver, re-certifications, and supply billing.
• Participate in NC Medicaid-certified training programs and ensure program compliance within 90 days of employment.
• Ensure timely updates to the CAP Business system and other documentation systems as required.
• Collaboration and Advocacy:
• Work closely with SWs and interdisciplinary team members to ensure a comprehensive approach to beneficiary care.
• Act as an advocate for program participants and their families to secure necessary resources and services.
• Work closely with service providers, community agencies, and healthcare professionals to optimize care outcomes.
• Provide training and support to families to empower them in managing their child's care.
• Continuing Education and Professional Development:
• Complete all state-mandated training and agency-required continuing education annually.
• Stay current on CAP guidelines, best practices, and new developments to enhance service delivery.
• All other duties as assigned.

Supervisory Responsibilities:

This position has no supervisory responsibilities.

Minimum Qualifications:

• Strong understanding of Medicaid programs and compliance requirements.
• Excellent communication and interpersonal skills to work effectively with families and multidisciplinary teams.
• Ability to manage multiple priorities and maintain detailed records.
• Experience working with medically fragile children or in pediatric healthcare settings and physically disabled adults with complex care needs.

Education and Experience:

Candidates must meet one of the following criteria:

Nursing Background:

• Current North Carolina Registered Nurse (RN) license with a two-year or four-year degree.
• One year of case management experience in home care, long-term care, personal care, or related work.
• Completion of an NC Medicaid-certified training program within 90 calendar days of employment.

Note: An individual with a bachelor's degree or who holds a nursing license as described above, without the number of years of experience, may be designated as an apprentice and shall be hired to act in the role of case manager. The supervisor of the case management shall provide direct supervision and approve all CAP/C workflow documentation and tasks.

Physical Demands and Work Environment:

• Must be able to lift a minimum of 10 lbs.
• Must be able to pull a minimum of 20 lbs.
• Must be able to squat, kneel, crawl, crouch, climb, and stoop.
• Required to regularly stand and walk.

RHA is an Equal Employment Opportunity Employer, prohibits discrimination based on the following protected categories: race, creed, color, national origin, nationality, ancestry, age, sex/gender, marital status, civil status, domestic partnership status, familial status, religion, affectional or sexual orientation, gender identity or expression, atypical hereditary cellular or blood trait, genetic information, liability for service in the Armed Forces of the United States, or disability.

Pre-employment screening:

• Complete criminal background
• Name checked in the registries. (OIG exclusions database, Child Abuse Registry, and Offenders Against Individuals with Developmental Disabilities)
• Drug testing
• Education verification and other credentialing based on position requirements.
• Proof of employment history or references (if required)
• Positions that require driving Proof of driver's license, driver's insurance, and vehicle, IF required for providing transportation for individuals.

We offer the following benefits to employees:

• Payactiv: early access to the money you've earned from hours you've already worked, before payday!
• Employee perks and discount program: to help you save money!
• Paid Time Off (full-time employees only)
• Health/Insurance (full-time employees only)
• 401(k) retirement savings program
• Wellbeing Programs: Physical, Emotional and Financial
• Chronic Disease management programs for hypertension and diabetes (for qualifying employees)
• Training: Free CPR, first aid, and job-specific training opportunities

*contract/contingent workers and interns do not qualify for any of the above benefits

EEO Statement RHA is an equal opportunity employer. In addition, we provide reasonable accommodation to qualified employees who have protected disabilities to the extent required by applicable laws, regulations, and ordinances. If you are an individual with a disability and need a reasonable accommodation to participate in the application process, please contact our solutions center.

About RHA:

At RHA Health Services, we help individuals with intellectual and developmental disabilities, mental health and/or substance use needs live their best lives. Our mission is to provide a safe and healthy environment while creating opportunities for personal outcomes.

For over 30 years, the people we serve and support have remained at the very center of everything we do. RHA currently provides services in North Carolina, Georgia, Pennsylvania