Care Manager Extender (Full-time Remote, North Carolina Based)

The Care Manager Extender supports Care Managers in delivering integrated, person-centered care coordination for members enrolled in the Alliance’s Tailored Plan. This role assists with non-clinical tasks, outreach, and administrative functions to ensure timely and effective care management services for individuals with complex behavioral health, intellectual/developmental disabilities (I/DD), and physical health needs.

Member Support and Outreach

• →Conduct outreach calls to members for appointment reminders, follow-ups, and engagement activities in accordance with organizational policies, regulatory requirements, and established workflows
• →Verify and update accuracy of demographic information with member and through online record review.  This includes confirming guardianship status
• →Provide education and support to individuals and LRP in learning about Tailored Care Management, Care Coordination, Care Teams
• →Assign members to the most appropriate Care Management or Care Coordination staff based on an assessment of geographic location, population served, benefit type, referral source, caseload capacity, urgency and complexity of care needs, and other established assignment criteria to promote timely access, equitable workload distribution, and effective member support
• →Other duties as assigned

Documentation and Compliance

• →Accurately document member interactions and activities in accordance with Alliance Health policies, NC DHHS standards, and Tailored Plan requirements
• →Obtain and upload all supporting documentation, Legally Responsible Person (LRP) verification, Opt-Out Change Form, and Letters on behalf of the member
• →Complete assigned tasks within required timeframes to maintain compliance with contractual and regulatory standards and meet productivity and performance expectations
• →Protect member confidentiality and comply with HIPAA and organizational privacy standards during all communications

Collaboration

• →Work closely with Care Managers, providers, and community partners to promote integrated care
• →Participate in team meetings and contribute to problem-solving for member needs
• →Coordinate with other team members to ensure smooth transition to assigned Care Manager/Care Coordinator

Professional Accountability

• →Use approved scripts, messaging, and communication methods while adapting conversations to meet member needs
• →Ensure outreach information provided to members is accurate, clear, and consistent with current program requirements and benefits
• →Escalate member concerns, barriers to engagement, urgent needs, complaints, or potential risks to the appropriate clinical or supervisory staff promptly
• →Demonstrate reliability through consistent attendance, timely completion of assigned outreach efforts, and adherence to work schedules
• →Participate in training, coaching, and continuous improvement activities to enhance outreach effectiveness and member engagement
• →Support equitable outreach practices by engaging members in a culturally responsive, nonjudgmental, and inclusive manner
• →Take ownership of resolving outreach-related issues within their scope of responsibility and seek guidance when appropriate
• →Make diligent efforts to engage members who may benefit most from additional support, following established outreach protocols and engagement strategies
• →Assist with locating and verifying member contact information using approved systems and resources
• →Support completion of outreach campaigns, assessments, screenings, and member engagement initiatives as directed
• →Build and maintain positive relationships with members through respectful, empathetic, and professional communication that promotes trust, engagement, and a positive member experience

Education & Experience

Required:

High school diploma or GED and a minimum of five (5) years of experience in healthcare, behavioral health, social services or care coordination. Familiarity with Medicaid Tailored Plan requirements and community resources in North Carolina required.

Or

Associate’s in human services and a minimum of three (3) years of experience in healthcare, behavioral health, social services or care coordination. Familiarity with Medicaid Tailored Plan requirements and community resources in North Carolina required.

Must reside in North Carolina and have reliable transportation for member visits and community events/meetings.

Preferred:

Associate’s degree in human services or related field preferred.

• Strong communication and organizational skills
• Ability to work independently and as part of a multidisciplinary team
• Microsoft Office suite and electronic medical records
• Evidence of the use of problem-solving skills. 
• Ability to apply basic knowledge of Microsoft Excel.
• Ability to utilize computer equipment and web-based software to conduct work.
• Ability to interact with various office staff as needed to support necessary workflows.
• Ability to interact with members, their families and other supports.
• Ability to communicate effectively with individuals and groups through spoken, written and electronic media.
• Ability to attend to detail, effectively prioritize and execute tasks in a timely manner.