Lead Care Manager

This is a remote position; however, candidates must reside in North Carolina. Approximately 10% travel may be required for occasional meetings or team events in Raleigh or Charlotte. The standard work schedule is Monday through Friday, 8:00 AM to 5:00 PM. Pediatric experience is high desired. Position Purpose: Oversees the care plans and care management activities of member needs primarily focused on behavioral health needs (including behavioral health, and social needs) to provide quality, cost-effective healthcare. Reviews and provides expert knowledge to inform personalized care plans for the most complex care members and provides guidance and/or support to the care management team. Oversees and reviews ongoing care plans/service plans, which may include which may include behavioral health and social determinant needs and works with care management team to identify providers, specialists, and community resources needed for care May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources Provides insight and guidance on developing care plans and triaging issues to appropriate behavioral healthcare providers for complex care plans/service plans for members with high level acuity Provides guidance and expert knowledge as appropriate to healthcare management team members (including behavioral) to ensure quality control over work, ensure identified services are accessible to members, and adherence to contract pol