About the role
LOCATION:Remote – must live in or near Buncombe County, North Carolina. The person in this position must live in North Carolina or within 40 miles of the North Carolina border. This position requires travel.
GENERAL STATEMENT OF JOB
The Care Manager Extender, hereafter referred to as Extenders, will support care managers in delivering Tailored Care Management and fulfilling the member contact requirements. Extenders will help Vaya Care Management best meet the needs of members, build efficient care teams by creating additional workforce capacity, and allow care managers and supervisors to focus on key tasks for assigned members as well as permit them additional time for members with intensive or complex needs. Certain components of Tailored Care Management will always be led by a care manager. However, some functions may be performed by an Extender as part of Tailored Care Management.
Extender will report to Care Manager and remain within the scope delineated in this job description and only performing functions within their training, scope, and abilities. Extenders will participate with the Care Manager and care team in supporting the member and integrate care team’s goal in a holistic approach and document interactions and activities within the identified administrative healthcare record according to departmental standards. Supervising care managers, care managers, and extenders will be in regular communication and coordinating efforts to mitigate duplicative or inappropriate outreach to assigned members.
*Remote candidates must live in/near the counties being served
ESSENTIAL JOB FUNCTIONS
Member Outreach, Support & Education
Extenders may support care managers in delivering Tailored Care Management by performing activities that fall within the below categories:
Performing general outreach, engagement, and follow-up with members;
Coordinating services/appointments (e.g., appointment/wellness reminders, arranging transportation);
Engaging in health promotion activities (as defined in the Tailored Care Management Provider Manual) and knowledge sharing; such as providing education on members’ chronic conditions; teaching self-management skills and sharing self-help recovery resources; Providing education on common environmental risk factors including but not limited to the health effects of exposure to second and third hand tobacco smoke and e-cigarette aerosols and liquids and their effects on family and children; and Promoting wellness and prevention programs.
Sharing information with the care manager and other members of the care team on the member’s circumstances;
Providing and tracking referrals and providing information and assistance in obtaining and maintaining community-based resources and social support services;
Participating in case conferences;
Support the care manager in assessing and addressing unmet health-related resource needs.
Other Duties
Other duties as assigned.
KNOWLEDGE, SKILL & ABILITIES
Extenders must complete the full Tailored Care Management training curriculum. Additionally, to ensure Extenders are sufficiently prepared and capable to perform their duties, extenders’ training must include practical (“hands-on”) training modalities and evaluation, which may include role play, use of call scripts, and practice sessions.
Tailored Care Management Training includes:
Tailored Plan eligibility and services
Whole-person health and unmet resource needs
Components of Health Home/Tailored Care Management
Ethics, boundaries, and personal safety
Building a trusting relationship
Community integration
Health promotion
I/DD- and TBI-specific trainings (if working with members from these communities)
Transitional care management
Skills to support health behavior change, including motivational interviewing
Person-centered needs assessment and care planning, including LTSS and other needs
Preparing members for and assisting them during emergencies and natural disasters
Infection control and prevention practices
Understanding virtual/telehealth applications
Needs of justice-involved individuals
Additional trainings for serving:
Children
Children with complex needs
Pregnant and postpartum persons with substance use disorder (SUD) or with SUD history
Members with LTSS need
Extenders must also demonstrate the following skills and abilities:
Ability to establish appropriate and respectful relationships/ partnerships with persons with a wide range of disabilities and healthcare conditions and their families.
Ability to interact professionally and effectively with persons who are upset and who disagree.
Ability to express ideas clearly and concisely orally and in writing.
Ability to work as a team member and under the direction of the Care Manager and the Care Management department.
Good customer service skills are essential.
QUALIFICATIONS & EDUCATION REQUIREMENTS
High school diploma or GED is required for this position. Must be at least 18 years of age and trained in Tailored Care Management. Must also meet one of the following requirements:
Be a person with lived experience with an I/DD or a TBI with demonstrated knowledge of and direct personal experience navigating the North Carolina Medicaid delivery system; or
Be a person with lived experience with a behavioral health condition who is a Certified Peer Support Specialist; or
A parent or guardian of an individual with an I/DD or a TBI or a behavioral health condition and has at least two years of direct experience providing care for and navigating the Medicaid delivery system on behalf of that individual (parent/guardian cannot serve as an extender for their family member); or
Has two years of paid experience performing the types of functions described in the “Duties/Responsibilities section of this role description in addition to one year of paid experience working directly with the Tailored Care Management eligible population.
Licensure/Certification Requirements:
None required. Certified PSS (Peer Support Specialist) and/ or WRAP (Wellness Recovery Action Plan) Facilitators preferred.
MENTAL/PHYSICAL REQUIREMENTS
Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
Mental concentration is required in all aspects of work.
RESIDENCY REQUIREMENTS: The person in this position is required to reside in North Carolina or within 40 miles of the NC border.
SALARY:Depending on qualifications & experience of candidate. This position is non-exempt and is eligible for overtime compensation.
DEADLINE FOR APPLICATION: Open Until Filled
APPLY:Vaya Health accepts online applications in our Career Center, please visit .
Vaya Health is an equal opportunity employer.
Originally posted on Himalayas