Clinical Care Advisor - IDD Team Lead

North Carolina residency is required. Travel within your assigned DSS Region is required. When you are not in the field, you will work virtually from your home. These roles are statewide field-based and require you to interact with patients, members, or providers 10-20% of the time.

About the Role

This is a collaborative role with the field care managers for the CFSP program, with the advisors supporting the care managers with consulting on IDD cases. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. Alternate locations may be considered if candidates reside within a commuting distance from an office. Per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

The Clinical Care Advisor - IDD Team Lead is responsible for coordinating operations and workflows related to Intellectual, Developmental & Disability (IDD) case management activities in support of CFSP Foster Care. Serves as a coach, performs case management telephonically and/or by home visits within the scope of licensure, and manages overall healthcare costs for the designated population via integrated (physical health/behavioral health) case management and whole person health. Manages the most complex cases and provides support to Special Programs case managers.

Responsibilities

• Experience with IDD population and 1915(i) services strongly preferred.
• Engage collaboratively with key stakeholders, including 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 as identified during assessment.
• Support member access to appropriate quality and cost-effective care and modify plan(s) 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 the needs of the member and incorporate that into care planning.
• Work closely with various state agencies.
• Maintain knowledge of the system of care philosophy; a spectrum of effective, community-based services and supports for those with or at risk for mental health or other challenges and their families, that is organized into a coordinated network.
• Build meaningful partnerships with designated populations and their families, and address cultural and linguistic needs, in order to help them function better at home, in the community, and throughout life.
• Evaluate health needs and identify applicable services and resources in conjunction with members and their families.
• Provide important information including patient education, medication reconciliation, and identification of community resources and assist with arrangement of follow-up care.
• Facilitate health rounds with other clinical-centered professionals to ensure whole person health. May lead and work on specialty projects and initiatives.
• Assist with process improvement activities.
• Train and mentor staff.
• Perform case/chart audits and ensure departmental compliance.
• Serve as a member of the leadership team.

Requirements

• Requires MS/MA in social work, counseling, or a related behavioral health field or a degree in nursing and a minimum of 7 years of clinical experience in social work counseling with a broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background.
• Requires an active, current, and valid license as an RN, LCSW (as applicable by state law and scope of practice), LMHC, LPC (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States.
• Travel to worksites and other locations as necessary.

We are unable to accommodate LCSW-A, LCMHC-A, or any other associate-level licenses.

Preferred Qualifications

• Experience with IDD population and 1915(i) services strongly preferred.
• Experience working with Children, Youth, and Families who are being served by Local Departments of Social Services through Foster Care and Adoptive Assistance programs is strongly preferred.
• Certified Case Manager certification is preferred.
• Experience serving the children and youth involved in Foster Care and Social Services.
• Prior experience in managing the delivery of services to meet the needs of children and youth with complex medical conditions is strongly preferred.
• Knowledge of resources, supports, services, and opportunities required for safe community living for populations receiving in-reach and transition services, including Complex Medical, Behavioral Health, and/or IDD is strongly preferred.
• Service delivery coordination, discharge planning, or behavioral health experience in a managed care setting preferred.

Benefits

• Merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement).
• Medical, dental, vision, short and long-term disability benefits.
• 401(k) + match, stock purchase plan, life insurance.
• Wellness programs and financial education resources.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.