Partners Behavioral Health Management

Role Description The primary purpose of this position is the initial screening, triage and referral (within the scope of practice) of members who call the 24/7/365 toll free access number seeking behavioral health services or anyone calling in with a crisis situation needing immediate assistance. The Clinician completes the STR, triages/assesses the consumer’s acuity and determines the type and intensity of service that the member needs and is eligible for and links them directly or indirectly with appropriate and available resources within state mandated timelines. Responsibilities - Initial screening of MH/SU/IDD treatment needs and clinical triage of members calling or walking in; determine if they potentially qualify for services and identify emergent, urgent or routine treatment needs. - Data entry into the electronic record, completion of appropriate forms, explanation of services, offering of provider choice using a slot schedule, managing the electronic wait list, and dispatch and collaboration with the First Responders or Mobile Crisis Management to stabilize acute crises. - Make referrals to clinical homes and crisis providers that meet the timeliness standards as defined by the state. - Provide information about local community resources, independent practitioners, and managed care companies for referrals for basic benefit and enhanced services. - Provide follow up calls to referral sources and members to ensure that they have been successfully engaged in services. - Provide back up and clinical consultation to other Licensed PartnersACCESS Clinicians and to Non-Licensed PartnersACCESS Qualified Specialists. - Support and incorporate Quality Management Principles and URAC requirements into the PartnersACCESS Department and the Partners Health Management organization. - Authorize admissions to state hospitals, ADATC, Three Way Hospitals, Level III Detox, Facility Based Crisis and all referrals to crisis services. - Process other acute care authorizations as needed. - Screenings are completed using standard and specialized computer programs. The approved screening form is a State designed STR form. - Inputs accurate information into the system and unlocks electronic service records with appropriate consents, and enters all necessary data elements into MIS system. - Provide technical and clinical assistance to First Responders, clinical home providers, and Mobile Crisis Management. - Establishes and maintains effective working relationships within the unit, agency, and service system. - Consistently demonstrates professionalism, tact and diplomacy in handling irate callers and/or working with contract providers and other external parties. - Participates in Unit Staff meetings, Agency Staff meetings, (All Staff) and assigned committees. Qualifications - Comprehensive knowledge of counseling, social work and/or psychological principles, techniques and practices to treat behavioral health conditions. - Specific knowledge includes: mental illness, substance use and intellectual and developmental disability diagnostic categories; individual and family dynamics; brief counseling and intervention techniques; psychiatric medications and their effects; mental health regulations; and an understanding of the North Carolina mental health system of service delivery. - Sound knowledge of MH/SU/IDD in order to determine eligibility for Medicaid and State supported services, appropriateness of referrals for treatment and assessment and the level of danger of the members calling for assistance. - Knowledge of the laws governing the treatment of mental illness, substance use and intellectual and developmental disabilities as well as the resources available in the community for treatment. - Working knowledge of Access to Care functions, consumer population, potential for crisis issues, confidentiality laws and program protocols/policies. - Excellent computer skills. - Ability to communicate effectively orally and in writing, have good keyboarding skills and be able to multi-task. - Ability to complete tasks independently, define problems, apply laws, policies and procedures to agency activities and use sound judgment in conducting screening, triage and referral. - Ability to use sound judgment and be able to maintain harmonious and effective working relationships with LME/MCO personnel, other professional disciplines, other agencies and the general public. - Ability to provide care management services and technical assistance to both members and providers. - Ability to assist members in highly stressful situations which may be life threatening to the member or public while at the same time facilitating a connection to crisis services and/or 911. - Ability to screen, skillfully triage and refer members to appropriate treatment modality. - Ability to maintain confidentiality. Education/Experience Required - Licensed Clinician or Registered Nurse (RN) and two years of clinical experience in MH/SU/IDD. - Must reside in North Carolina. Education/Experience Preferred - Bilingual in English/Spanish preferred; NC Registered Nurse (RN) preferred. Licensure/Certification Requirements - Current unrestricted LCSW, LPC, LPA, LMFT or LCAS licensure with the appropriate professional board of licensure in the state of North Carolina or licensed to practice as a Registered Nurse in North Carolina by the N. C. Board of Nursing. - Employee is responsible for complying with respective licensure board’s continuing education/training requirements. - An active professional clinical license is required for this position. Benefits - Competitive Compensation & Benefits Package! - Annual incentive bonus plan. - Medical, dental, and vision insurance with low deductible/low cost health plan. - Generous vacation and sick time accrual. - 12 paid holidays. - State Retirement (pension plan). - 401(k) Plan with employer match. - Company paid life and disability insurance. - Wellness Programs. - Public Service Loan Forgiveness Qualifying Employer.

Role Description The primary purpose of this position is the initial screening, triage and referral (within the scope of practice) of members who call the 24/7/365 toll free access number seeking behavioral health services or anyone calling in with a crisis situation needing immediate assistance. The Clinician completes the STR, triages/assesses the consumer’s acuity and determines the type and intensity of service that the member needs and is eligible for and links them directly or indirectly with appropriate and available resources within state mandated timelines. Role and Responsibilities - Initial screening of MH/SU/IDD treatment needs and clinical triage of members calling or walking in; determine if they potentially qualify for services and identify emergent, urgent or routine treatment needs. - Data entry into the electronic record, completion of appropriate forms, explanation of services, offering of provider choice using a slot schedule, managing the electronic wait list, and dispatch and collaboration with the First Responders or Mobile Crisis Management to stabilize acute crises. - Make referrals to clinical homes and crisis providers that meet the timeliness standards as defined by the state. - Provide information about local community resources, independent practitioners, and managed care companies for referrals for basic benefit and enhanced services. - Provide follow up calls to referral sources and members to ensure that they have been successfully engaged in services. - Provide back up and clinical consultation to other Licensed PartnersACCESS Clinicians and to Non-Licensed PartnersACCESS Qualified Specialists. - Support and incorporate Quality Management Principles and URAC requirements into the PartnersACCESS Department and the Partners Health Management organization. - This position demands a high level of accuracy and confidentiality. Information must be handled according to State standards/rules, State and Federal laws and Local Management Entity Standards- Procedures and Policies Protocol. - Authorize admissions to state hospitals, ADATC, Three Way Hospitals, Level III Detox, Facility Based Crisis and all referrals to crisis services. - Process other acute care authorizations as needed. - Screenings are completed using standard and specialized computer programs. The approved screening form is a State designed STR form. - Inputs accurate information into the system and unlocks electronic service records with appropriate consents, and enters all necessary data elements into MIS system. - Provide technical and clinical assistance to First Responders, clinical home providers, and Mobile Crisis Management. - Establishes and maintains effective working relationships within the unit, agency, and service system. - Consistently demonstrates professionalism, tact and diplomacy in handling irate callers and/or working with contract providers and other external parties. - Participates in Unit Staff meetings, Agency Staff meetings, (All Staff) and assigned committees. Qualifications - Comprehensive knowledge of counseling, social work and/or psychological principles, techniques and practices to treat behavioral health conditions. - Specific knowledge includes: mental illness, substance use and intellectual and developmental disability diagnostic categories; individual and family dynamics; brief counseling and intervention techniques; psychiatric medications and their effects; mental health regulations; and an understanding of the North Carolina mental health system of service delivery. - Sound knowledge of MH/SU/IDD in order to determine eligibility for Medicaid and State supported services, appropriateness of referrals for treatment and assessment and the level of danger of the members calling for assistance. - Knowledge of the laws governing the treatment of mental illness, substance use and intellectual and developmental disabilities as well as the resources available in the community for treatment. - Working knowledge of Access to Care functions, consumer population, potential for crisis issues, confidentiality laws and program protocols/policies. - Excellent computer skills. - Ability to communicate effectively orally and in writing, have good keyboarding skills and be able to multi-task. - Ability to complete tasks independently, define problems, apply laws, policies and procedures to agency activities and use sound judgment in conducting screening, triage and referral. - Ability to use sound judgment and be able to maintain harmonious and effective working relationships with LME/MCO personnel, other professional disciplines, other agencies and the general public. - Ability to provide care management services and technical assistance to both members and providers. - Ability to assist members in highly stressful situations which may be life threatening to the member or public while at the same time facilitating a connection to crisis services and/or 911. - Ability to screen, skillfully triage and refer members to appropriate treatment modality. - Ability to maintain confidentiality. Education/Experience Required - Licensed Clinician or Registered Nurse (RN) and two years of clinical experience in MH/SU/IDD. - Must reside in North Carolina. Education/Experience Preferred - Bilingual in English/Spanish preferred; NC Registered Nurse (RN) preferred. Licensure/Certification Requirements - Current unrestricted LCSW, LPC, LPA, LMFT or LCAS licensure with the appropriate professional board of licensure in the state of North Carolina or licensed to practice as a Registered Nurse in North Carolina by the N. C. Board of Nursing. - Employee is responsible for complying with respective licensure board’s continuing education/training requirements. - An active professional clinical license is required for this position. Benefits - Annual incentive bonus plan. - Medical, dental, and vision insurance with low deductible/low cost health plan. - Generous vacation and sick time accrual. - 12 paid holidays. - State Retirement (pension plan). - 401(k) Plan with employer match. - Company paid life and disability insurance. - Wellness Programs. - Public Service Loan Forgiveness Qualifying Employer.

Role Description This position assists in the enrollment, maintenance, development and management of the Provider Network for members who have been identified as having mental health, substance use or intellectual development disability needs. Role and Responsibilities: - Responsible for reviewing, monitoring and ensuring compliance with facility licensure, national accreditation requirements, clinical coverage policies and other requirements related to the provision of behavioral health services. - Responsible for receiving, reviewing, analyzing and entering time sensitive and confidential provider information. - Responsible for ensuring that providers are properly enrolled in NC Tracks prior to enrolling them into the system. - Demonstrates understanding of Tailored Plan and Medicaid Direct health plans. - Responsible for managing, tracking and filing information submitted to and information received from providers related to ongoing maintenance of provider enrollment and contracting. - Responsible for managing, processing, tracking and filing requests from providers to join the network and requests from providers to make changes to their contracts. - Responsible for regular follow-up of status of submitted requests to join the network and provider maintenance requests. - Responsible for resolving issues and supporting providers regarding their requests to contract with or make changes to their contract with Partners. - Responsible for monitoring and follow-up associated with the provider enrollment file and the provider network file. - Participates in performance improvement activities. - Receive and process requests for access to Partners Provider Portal. - Composes letters, memos and emails to internal and external contacts. - Researches questions related to joining the Partners provider network and/or change requests and responds to internal and external contacts regarding concerns related to delays and inconsistencies in information. - Demonstrates the ability to communicate professionally and clearly in both verbal and written form both internally and externally. - Monitors and updates provider information as required. - Accurately and clearly documents process steps, dates and work status. - Verifies providers meet the requirements to provide services in the Network according to parameters determined for qualifications and needs of the Network. - Interprets audit results, identifies trends/patterns that impact service/system quality, and then implements interventions aimed at addressing these trends/patterns with the outcome of services delivery to consumers at the highest degree of quality. - Collaborates with Quality Management Department, Program Integrity Department, Provider Network Relations, Member Engagement, and Community Engagement to collect information related to quality of care for the purpose of enrollment of providers. - Participates in complaint monitoring reviews/focused reviews/special investigative team reviews as requested by the Member Engagement Department, the Program Integrity Department, the Quality of Care Committee, Network Management Committee, or as indicated by another agency or departmental identified need. - Serves as a resource to other departments within the LME/MCO on provider-related issues. - Serves as a liaison with other departments within the LME/MCO and with various NC DHHS Departments, per rule requirements, to coordinate Specialist’s activities and findings. - Participates in Provider Forums as requested and provides technical support and assistance to Provider Councils as needed. - Participates in oversight and monitoring reviews of the MCO including but not limited to EQR and NCQA reviews as appropriate. - Responsible for interpreting and assisting in developing and maintaining policies and procedures. Qualifications - Considerable knowledge of the laws, regulations and policies that govern the program. - Exceptional interpersonal and communication skills. - Strong problem solving, negotiation, arbitration, and conflict resolution skills. - Excellent computer skills and proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint). - Demonstrated ability to verify documents for accuracy and completeness; to understand and apply laws, rules and regulations to various situations; to apply regulations and policies for maintenance of consumer medical records, personnel records, and facility licensure requirements. - Ability to make prompt independent decisions based upon relevant facts. - Ability to establish rapport and maintain effective working relationships. - Ability to act with tact and diplomacy in all situations. - Ability to maintain strict confidentiality in all areas of work. - Ability to analyze and interpret policy and procedural guidelines and to resolve problems and questions, independently. - Ability to complete non-routine activities and tasks that require deviation from established procedures which includes the ability to choose the appropriate course of action and recognize the existence of and differences among situations. - Ability to use initiative and judgment in resolving problems not covered by established priorities or prior experience. Requirements - Bachelor’s Degree and two (2) years of credentialing, provider enrollment, auditing or monitoring experience in MH/SU/I-DD. - Must have ability to travel. - MUST reside in North Carolina. Benefits - Competitive Compensation & Benefits Package! - Annual incentive bonus plan. - Medical, dental, and vision insurance with low deductible/low cost health plan. - Generous vacation and sick time accrual. - 12 paid holidays. - State Retirement (pension plan). - 401(k) Plan with employer match. - Company paid life and disability insurance. - Wellness Programs. - Public Service Loan Forgiveness Qualifying Employer.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This position is responsible for providing proactive intervention and care management consultation and support to promote high quality, whole person care for individuals with behavioral health (BH), intellectual/developmental disabilities (IDD), and/or traumatic brain injury (TBI) with or at risk for physical health complexities. The focus of this position is to ensure that individuals receive appropriate collaborative care assessment and services. This is a mobile position with work done in a variety of locations. Travel is an essential function of this position. Responsibilities - Provides physical health expertise and consultation - Serves as the point of contact regarding collaborative care for care management teams - Uses available data and medical information to provide proactive consultation and advice to the dedicated care managers regarding action steps needed to promote and/or improve member health - Provides direct care management support as needed (informing, educating, linking, phone communication with member or collaterals, participation in care team meetings) - Participates in clinical huddles/rounds with care managers, clinical and medical leadership - Takes lead on scheduling, presenting and providing updates in clinical huddles when indicated - Facilitates medication reconciliation - Assists department leadership in staff training and development, supporting care managers in development of necessary skills and resources to improve member health status - Provides guidance to care management staff on using Healthwise topics for health education and promotion with members - Measures results of intervention and treatment, including reduction in high risk events and inappropriate service utilization - Assists in quality of care monitoring through review of care plans, medical records, critical incident reports and other sources of information and provides consultation on quality of medical care or recommends areas for quality improvement - Analyzes medical, psychiatric, behavioral health diagnosis and medication data reports to identify potential contraindications in treatment on a scheduled basis - Participates actively in learning collaborative with other Care Management nurses - Will serve as tailored care manager for an identified high cost/high risk population and complete all needed assessments and reviews for care management - Will participate and complete other duties as assigned Qualifications - Ability to provide consultative supports for physical health diagnosis and treatment to include education, assessment, and care planning for whole person care - Understanding of the Diagnostic and Statistical Manual of Mental Disorders (current version) - Considerable knowledge of the IDD/TBI/MH/SUD service array provided through the network of the LME/MCO’s Providers - Knowledge of NC Medicaid, Managed Care, NC Innovations Waiver, 1915i option, LTSS, Tailored Plan and Standard Plans - Ability to analyze data and use data to drive decision-making - Ability to provide effective and clinically sound consultation/education/training to others - Ability to establish and maintain positive and effective working relationships with others both within the agency and community - Exceptional interpersonal and communication skills - Excellent computer skills including proficiency in Microsoft Office products (Word, Excel, Outlook, and PowerPoint) - Excellent problem solving, negotiation, arbitration, and conflict resolution skills - Detail-oriented, able to organize multiple tasks and priorities and effectively manage projects from start to finish - Ability to make prompt independent decisions based upon relevant facts, to establish rapport and maintain effective working relationships - Ability to change the focus of his/her activities to meet changing priorities Requirements - Licensed to practice as a Registered Nurse in North Carolina and two years of experience in intellectual and developmental disabilities, traumatic brain injury, and/or behavioral health - Must reside in North Carolina - Must have ability to travel regularly as needed to perform job duties Preferred Experience - Licensed to practice as a Registered Nurse in North Carolina and two years of experience in psychiatric nursing with dually diagnosed MH/IDD; care management/care coordination experience - Experience in collaborative care - Fluency in written and verbal bi-lingual Spanish/English language expertise Licensure/Certification Requirements - Must be licensed as a Registered Nurse in North Carolina - Employee is responsible for complying with respective licensure board’s continuing education/training requirements in order to maintain an active license Benefits - Competitive Compensation & Benefits Package - Annual incentive bonus plan - Medical, dental, and vision insurance with low deductible/low cost health plan - Generous vacation and sick time accrual - 12 paid holidays - State Retirement (pension plan) - 401(k) Plan with employer match - Company paid life and disability insurance - Wellness Programs - Public Service Loan Forgiveness Qualifying Employer

Competitive Compensation & Benefits Package! Position eligible for – - Annual incentive bonus plan - Medical, dental, and vision insurance with low deductible/low cost health plan - Generous vacation and sick time accrual - 12 paid holidays - State Retirement (pension plan) - 401(k) Plan with employer match - Company paid life and disability insurance - Wellness Programs - Public Service Loan Forgiveness Qualifying Employer See attachment for additional details. Office Location: Available for any of Partners locations; Remote Option Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Primary Purpose of Position: The Provider Engagement & Outreach Specialist serves as a liaison between Partners Health Management and healthcare/physical health providers to drive quality improvement, practice transformation, and provider engagement. This role supports physical health providers in implementing evidence-based workflows, optimizing care delivery models, and aligning with value-based care initiatives. The Specialist also leads outreach efforts to foster collaborative relationships, deliver educational resources, and support providers in meeting performance and compliance benchmarks. Roles and Responsibilities: - Support medical providers in transforming care delivery through implementation of patient-centered medical home(PCMH), value-based care models, and quality improvement initiatives. - Engage directly with providers and healthcare teams across North Carolina to build strong partnerships, understand their unique challenges, and provide tailored assistance - Conduct on-site and virtual practice visits to assess workflows, identify improvement opportunities, and provide technical assistance and resources. - Analyze and utilize performance data (e.g., HEDIS, Medicaid measures) to collaborate with providers to design targeted interventions that improve care quality and patient outcomes. - Assist practices with change management strategies to enhance patient outcomes and operational efficiency - Act as a liaison in supporting providers in adopting value-based care practices, that enhance clinical efficiency and patient outcomes - Develop and disseminate outreach materials, toolkits, and communication strategies to strengthen provider relationships. - Stay abreast of emerging best practices, payer requirements, and regulatory changes affecting provider performance and transformation. - Deliver training and coaching on practice transformation topics, data use, and workflow redesign - Track provider progress, document interactions, and report outcomes and barriers to leadership for continuous program improvement. - Work directly with physicians, clinical teams, and administrative staff to improve care delivery, enhance patient outcomes, and increase performance. - Collaborate with internal stakeholders to align resources and interventions - Support practice transformation initiatives that drive sustained improvements in care quality and operational efficiency - Work with providers to encourage preventive service utilization and effective chronic condition management among their patient populations - Assist clinicians achieve measurable improvements in health outcomes and patient satisfaction by fostering patient engagement and adherence to recommended care plans Knowledge, Skills and Abilities: - Deep understanding of value-based care models, and healthcare quality programs. - Experience in healthcare practice transformation, care delivery redesign or clinical operations - Experience engaging and coaching clinical teams (physicians, nurses, and practice managers) - Familiarity with health equity initiatives and strategies to address social drivers of health. - Experience in Project Management and familiarity in process mapping and workflow analysis tools. - Knowledge of and ability to explain and apply the provisions of contractual practices adopted by Partners Health Management and required by NC Division of Health Benefits. - Demonstrate working knowledge of HEDIS quality measures and reporting requirements to support accurate provider education and engagement - Collaborate with providers and internal teams to close care gaps and ensure compliance with HEDIS and other quality initiatives. - Experience working with large multi-site practices. - Ability to analyze clinical and operational data to drive improvement initiatives. - Excellent facilitation and project management skills and familiarity in process mapping and workflow analysis tools. - Strong problem solving, decision-making and negotiating skills. - Exceptional interpersonal skills and strong written and verbal communication skills. - Excellent organizational skills. - Ability to multi-task and meet deadlines. - Considerable knowledge of the laws, regulations and policies that govern the program, which includes and is not limited to contractual requirements adopted by NC Division of Health Benefits and other governmental oversight agencies. - Strong problem solving, negotiation, arbitration, and conflict resolution skills. - Excellent computer skills and proficiency in Microsoft Office products (such as Word, Excel, Outlook, and PowerPoint. - Demonstrated ability to verify documents for accuracy and completeness; to understand and apply laws, rules and regulations to various situations; to apply regulations and policies for maintenance of consumer medical records, personnel records, and facility licensure requirements. - Ability to make prompt independent decisions based upon relevant facts. - Ability to establish rapport and maintain effective working relationships. - Ability to act with tact and diplomacy in all situations. - Ability to maintain strict confidentiality in all areas of work. - Experience with Electronic Health Records (HER) for clinical processes Education and Experience Required: Bachelor’s degree and a minimum of four years of experience in managed care or a related field with a healthcare provider or insurer/payer. Relevant areas may include provider relations, network development or design, provider engagement services, contract management, or patient financial services. Experience in auditing, accounting, or finance is also applicable. A combination of relevant education and experience may be considered in lieu of a Bachelor’s degree. Must be able to travel as required. 4-6 years of significant and relevant work experience in medical practice management in lieu of educational requirements may be accepted, particularly with significant administrative experience in a clinic setting. Must have the ability to travel as indicated. Other requirements: Must reside in North Carolina or within 40 miles of the NC border. Education and Experience Preferred: Bachelor’s degree in Nursing, Public Health, Healthcare Administration, or a related field (Master’s degree preferred). Deep understanding of value-based care models, healthcare quality programs, and population health initiatives. Demonstrated experience in practice transformation roles and practice support.

**This is a mobile position which will work primarily out in the assigned communities.** Join a Mission That Moves With You: Mobile/Remote Care Management across NC Why You’ll Love Working Here In 2026, the future of healthcare is in the community. As an I/DD Care Manager at Partners, you aren't just managing files—you are the architect of a better life for individuals with Intellectual and Developmental Disabilities. We offer a role that balances clinical excellence with geographic flexibility, supported by one of the most stable and competitive benefits packages in North Carolina. The Perks of Joining Our Team: - Work Where You Live: Fully mobile/remote role serving the counties you live in, work in and call home. - Financial Security: State Retirement Pension plan, 401(k) with employer match, company paid life and disability insurance, and an annual incentive bonus. - Health & Wellness: Low-deductible medical/dental plans and generous vacation + sick time accruals. - Student Loan Relief: We are a Public Service Loan Forgiveness (PSLF) Qualifying Employer—let your work pay off your education. - Celebrate Life: 12 paid holidays and dedicated wellness programs. See attachment for additional details. Location: Available for Gastonia NC location; Mobile/Remote position Projected Hiring Range: Depending on Experience Closing Date: Open Until Filled Your Impact & Role As a Partners Care Manager, you will serve as the primary point of contact and navigator for members with I/DD and/or dually diagnosed members. You will lead "Team Based Care," ensuring our members receive holistic support that integrates physical health, behavioral health, and long-term supports and services. What a Typical Week Looks Like: - Meet Members Where They Are: Meet members in their communities to assess their current and projected needs to build Person-Centered Care Plans/Individual Support Plans (ISP) to get them closer to achieving their vision for their lives. - Integrative Leadership: Facilitate interdisciplinary team meetings to ensure doctors, specialists, providers and families are all moving in the same direction to meet the member’s needs. - Transition Expert: Guide members through life’s big changes—moving from school to adulthood, returning home from care facilities, gaining optimal independence and finding the right combination of paid supports to maintain or increase overall health and wellness. - Empowerment: Educate members and families on their rights and connect them to the array of services and our network of providers to secure their future. Who You Are - A Mobile Professional: A North Carolina resident and you thrive on the road and value the autonomy of a community-based role. Travel is an essential part of how you connect with those you serve. - A Systems Navigator: You understand (or are eager to master) Medicaid regulations, 1915i services, and the Tailored Plan landscape. - A Person-Centered Planner: You believe there is no "one size fits all" solution in care management. You bring a voice to vulnerable individuals through your strengths of observation, connecting the dots, supporting their journey through your planning skills. - Qualified Candidate to apply:You’ve earned your degree and put it to work! Congratulations! You are who we are looking for if one of these many different scenarios describe you… - You have earned a Bachelor’s degree in a human services field like psychology, social work, nursing or other relevant human services field: - and you bring with you a minimum of 2 years full-time experience working with individuals with Intellectual and Developmental Disabilities - and at least 2 years of your work experience was with people with significant Long-Term Services and Supports (LTSS) needs due to their disability in a setting where they receive care in the community OR - You earned a Bachelor’s degree outside the human services field - and you have at least 4 years full-time experience working with individuals with Intellectual and Developmental Disabilities. - and at least 2 years of your work experience was with people with significant Long-Term Services and Supports (LTSS) needs due to their disability in a setting where they receive care in the community OR - You earned a Master’s degree - and have a minimum of 1 year full time experience working with individuals with Intellectual and Developmental Disabilities - and at least 2 years of your work experience was with people with significant Long-Term Services and Supports (LTSS) needs due to their disability in a setting where they receive care in the community - You reside in North Carolina - You have the ability to travel regularly as needed to perform job duties

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This is a mobile position which will work primarily out in the assigned communities. As an I/DD Care Manager at Partners, you aren't just managing files—you are the architect of a better life for individuals with Intellectual and Developmental Disabilities. - Serve as the primary point of contact and navigator for members with I/DD and/or dually diagnosed members. - Lead "Team Based Care," ensuring members receive holistic support that integrates physical health, behavioral health, and long-term supports and services. What a Typical Week Looks Like: - Meet members in their communities to assess their current and projected needs to build Person-Centered Care Plans/Individual Support Plans (ISP). - Facilitate interdisciplinary team meetings to ensure doctors, specialists, providers, and families are aligned to meet the member’s needs. - Guide members through life’s big changes—moving from school to adulthood, returning home from care facilities, gaining optimal independence, and finding the right combination of paid supports. - Educate members and families on their rights and connect them to services and our network of providers. Qualifications - Bachelor’s degree in a human services field like psychology, social work, nursing, or other relevant human services field with a minimum of 2 years full-time experience working with individuals with Intellectual and Developmental Disabilities. - OR Bachelor’s degree outside the human services field with at least 4 years full-time experience working with individuals with Intellectual and Developmental Disabilities. - OR Master’s degree with a minimum of 1 year full-time experience working with individuals with Intellectual and Developmental Disabilities. - At least 2 years of work experience with people with significant Long-Term Services and Supports (LTSS) needs due to their disability in a community care setting. - Fluent in English and Spanish (verbal and written). - Ability to travel regularly as needed to perform job duties. Requirements - North Carolina resident who thrives on the road and values the autonomy of a community-based role. - Understanding or eagerness to master Medicaid regulations, 1915i services, and the Tailored Plan landscape. - Belief in a person-centered approach to care management. Benefits - Fully mobile/remote role serving the counties you live in, work in, and call home. - State Retirement Pension plan, 401(k) with employer match, company paid life and disability insurance, and an annual incentive bonus. - Low-deductible medical/dental plans and generous vacation + sick time accruals. - Public Service Loan Forgiveness (PSLF) Qualifying Employer. - 12 paid holidays and dedicated wellness programs.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This position is responsible for facilitating the review of service plans and service authorization requests to ensure that individuals are receiving the most appropriate services at a given time. - Review of Service Plans and Authorization Requests to ensure that all required documents are submitted - Approve requests based on an algorithm for “auto approval” of the plan and authorization requests - Refer plan and authorization requests that cannot be “auto approved” to Licensed Utilization Management Reviewer for medical necessity review - Administratively deny incomplete requests - Onboarding/training/mentoring of new staff as requested by leadership - Other duties as needed to support the Supervisor, Manager, and Director Qualifications - Comprehensive knowledge of mental illness and diagnostic categories - Knowledge of the assessment and treatment of developmental disabilities, with or without co-occurring mental illness - Knowledge of the 1915 (b) (c) waiver - Knowledge of psychiatric medications and side effects - Knowledge of evidence-based practices - Knowledge of appropriate treatments for major diagnostic categories - Exceptional interpersonal skills and highly effective communication ability - Problem solving, negotiation, and conflict resolution skills - Awareness of cultural diversity - Excellent computer skills including proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc) - Detail oriented, able to independently organize multiple tasks and priorities Requirements - A Bachelor’s Degree in a Human Services field - Two (2) years of post-degree I/DD experience Benefits - Annual incentive bonus plan - Medical, dental, and vision insurance with low deductible/low cost health plan - Generous vacation and sick time accrual - 12 paid holidays - State Retirement (pension plan) - 401(k) Plan with employer match - Company paid life and disability insurance - Wellness Programs - Public Service Loan Forgiveness Qualifying Employer