Clinical Care Advisor - Complex Medical Healthy Blue Care Together CFSP

Overview

$3,500 SIGN ON BONUS

Disabilities (I/DD) services, long term services and supports, unmet health-related resource needs, and integrated care management. We envision a North Carolina where all children and families thrive in safe, stable, and nurturing homes.

North Carolina residency is required!

• Region 6 counties:
  Bladen, Brunswick, Carteret, Columbus, Craven, Cumberland, Duplin, Jones, Lenoir, New Hanover, Onslow, Pamlico, Pender, Perquimans, and Sampson
• Region 7 counties:
  Beaufort, Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Hyde, Martin, Pasquotank, Perquimans, Tyrrell, and Washington

Clinical Care Advisor - Complex Medical

$3,500 SIGN ON BONUS

We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system so that they receive seamless, integrated, and coordinated health care. Within the Children and Families Specialty Plan (CFSP), members will have access to basic benefits and services, including Physical health, Behavioral health, Pharmacy, Intellectual/Developmental Disabilities (I/DD) services, long term services and supports, unmet health-related resource needs, and Integrated care management.

We envision a North Carolina where all children and families thrive in safe, stable, and nurturing homes.

Location:

• Region 6 counties:
  Bladen, Brunswick, Carteret, Columbus, Craven, Cumberland, Duplin, Jones, Lenoir, New Hanover, Onslow, Pamlico, Pender, Perquimans, and Sampson
• Region 7 counties:
  Beaufort, Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Hyde, Martin, Pasquotank, Perquimans, Tyrrell, and Washington

Travel within your assigned DSS Region is required. When not in the field, you will work virtually from your home. These roles are statewide field-based and require interaction with patients, members, or providers in person four to five days per week. This is a collaborative role with field care managers for the CFSP program, supporting care managers with consulting on complex medical or IDD cases.

This field-based role enables you to operate primarily in the field, traveling to client sites or designated locations as needed, with occasional office attendance for meetings or training. This approach ensures flexibility and direct, hands-on engagement.

Please note that per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law.

• Engage collaboratively with families, foster parents, and service teams to craft and sustain individualized treatment plans.
• Conduct assessments to identify individual needs.
• Develop comprehensive care plans to address objectives and goals identified during assessment.
• Support member access to appropriate quality and cost-efficient care and modify plans as needed.
• Coordinate with internal and external resources to meet identified needs of the member in terms of integrated (physical and behavioral) whole-person care.
• Coordinate social determinants of health to meet member needs and incorporate them into care planning.
• Work closely with various state agencies.
• Maintain knowledge of system of care philosophy and a spectrum of effective community-based services and supports.
• Build meaningful partnerships with designated populations and families, addressing cultural and linguistic needs to help them function better at home and in the community.
• Evaluate health needs and identify applicable services and resources with members and families.
• Provide patient education, medication reconciliation, and identification of community resources; assist with follow-up care arrangements.
• Facilitate health rounds with other clinically focused professionals to ensure whole-person health.
• Lead and participate in specialty projects and initiatives as appropriate.
• Assist with process improvements and train/mentor staff.
• Perform case/chart audits and ensure departmental compliance.
• Serve as a member of the leadership team.

• Requires an active and current license as an LCSW, LCMHC, LPC, LMFT, or RN issued by the state of North Carolina.
• Requires an MS/MA in social work, counseling, or a related behavioral health field, or a degree in nursing.
• Requires three (3) years of experience providing care management, case management, or care coordination to individuals served by the child welfare system.

• Experience working with Children, Youth, and Families served by Local Departments of Social Services through Foster Care and Adoptive Assistance programs is strongly preferred.
• Certified Case Manager Certification is highly preferred.
• Experience serving children and youth involved in Foster Care and Social Services is strongly preferred.
• Experience managing delivery of services to meet the needs of children and youth…