CAP Case Manager / Social Worker / PT / Gaston County / Flexible Hours

About the role

We are hiring for a CAP Case Manager / Social Worker / PT position in Gaston County. This role offers flexible hours and the chance to make a real difference in the lives of individuals with intellectual, developmental disabilities, and those facing mental health and substance use challenges.

Responsibilities

• 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, other 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.
• Review and update care plans at least every 12 months or when the status of the beneficiary changes.
• Assist beneficiaries and families in understanding the plan of care and making informed choices.
• Link beneficiaries and their families to necessary services, equipment, and supplies to support care in the home.
• Collaborate with community resources, healthcare providers, and other agencies to ensure comprehensive care delivery.
• Initiate appropriate referrals and utilize community resources for planning and service coordination.
• Provide ongoing monitoring of services through monthly phone calls and home visits, documenting observations, and beneficiary progress.
• Evaluate the effectiveness of care plans and services, recommending or implementing changes as needed to achieve desired outcomes.
• Maintain accurate, up-to-date case management documentation within the system, ensuring compliance with state and agency guidelines.
• Provide emotional support and basic 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.
• Document and ensure compliance with 10A NCAC 27G.0202 and other regulatory guidelines.
• Complete all required records per agency policy and the State CAP manual, including discharge summaries when CAP services are completed.
• 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.
• Collaborate with RNs and interdisciplinary team members to ensure a comprehensive approach to beneficiary care.
• Advocate for program participants and their families to secure necessary resources and services.
• Serve as a liaison between beneficiaries, families, and external providers to address care needs effectively.
• Provide training and support to families to empower them in managing their child’s care.
• 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.

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.

Skills

• 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.

Benefits

• 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

Pay

Details on pay will be provided during the interview process.

Schedule

The schedule for this role is flexible.