Clinical Care Advisor - Intellectual & Developmental Disabilities (IDD)

Clinical Care Advisor - Intellectual & Developmental Disabilities (IDD)

We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system so that they receive seamless, integrated, and coordinated health care. Within the Children and Families Specialty Plan (CFSP), and regardless of where a member lives, they will have access to the same basic benefits and services, including physical health, behavioral health, pharmacy, intellectual/developmental disabilities (I/DD) services, long term services and supports, unmet health-related resource needs, and integrated care management. We envision a North Carolina where all children and families thrive in safe, stable, and nurturing homes.

North Carolina residency is required! Location: We are currently seeking people throughout the State of North Carolina in the following DSS Regions:

• Region 1 counties: Buncombe, Cherokee, Clay, Graham, Haywood, Henderson, Madison, Polk, Swain, Transylvania, Yancey, Macon, Jackson, Mitchell.
• Region 2 counties: Alexander, Alleghany, Ashe, Avery, Burke, Caldwell, Catawba, Cleveland, Gaston, Iredell, Lincoln, McDowell, Rutherford, Watauga, Wilkes.
• Region 3 counties: Alamance, Caswell, Chatham, Davidson, Davie, Durham, Forsyth, Guilford, Orange, Person, Randolph, Rockingham, Stokes, Surry, Yadkin.
• Region 4 counties: Anson, Cabarrus, Harnett, Hoke, Lee, Mecklenburg, Montgomery, Moore, Richmond, Robeson, Rowan, Scotland, Stanly, Union.
• Region 5 counties: Edgecombe, Franklin, Granville, Halifax, Johnston, Nash, Northampton, Pitt, Vance, Wake, Warren, Wayne, Wilson, Greene.
• Region 6 counties: Bladen, Brunswick, Carteret, Columbus, Craven, Cumberland, Duplin, Jones, Lenoir, New Hanover, Onslow, Pamlico, Pender, Perquimans, Sampson.
• Region 7 counties: Beaufort, Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Hyde, Martin, Pasquotank, Perquimans, Tyrrell, Washington.

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 in person 10-20% of the time. This is a collaborative role with the field care managers for the CFSP program with the advisors supporting the care managers with consulting on complex medical or 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. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.

Please note that 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 - Intellectual & Developmental Disabilities (IDD) is responsible for the Children and Families Specialty Plan integrated physical health and behavioral health care management teams and the development, implementation and coordination of a comprehensive clinical program designed specifically to manage the health and wellness outcomes of youth in foster care and adoption assistance, including Intellectual & Developmental Disabilities (IDD) members with varying degrees of medical and behavioral health complexity and acuity. Manages overall healthcare costs, case management and whole person health.

How you will make an impact:

• Engage collaboratively with key stakeholdersincluding families, foster parents, and service teamsto craft and sustain individualized treatment plans.
• Conducts assessments to identify individual needs.
• Develops comprehensive care plan to address objectives and goals as identified during assessment.
• Supports member access to appropriate quality and cost effective care and modifies plan(s) as needed.
• Coordinates with internal and external resources to meet identified needs of the member in terms of integrated (physical and behavioral) whole person care.
• Coordinates social determinants of health to meet the needs of the member and incorporates that into care planning.
• Works closely with various state agencies.
• Maintains 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.
• Builds meaningful partnerships with designated populations and their families, and addresses cultural and linguistic needs, in order to help them function better at home, in the community, and throughout life.
• Evaluates health needs and identifies applicable services and resources in conjunction with members and their families.
• Provides important information including patient education, medication reconciliation, and identification of community resources and assists with arrangement of follow-up care.
• Facilitates health rounds with other clinical centered professionals to ensure whole person health.
• May lead and work on specialty projects and initiatives.
• Assists with process improvements activities.
• Trains and mentors staff.
• Performs case/chart audits and ensures departmental compliance.
• Serves as a member of the leadership team.

For the State of North Carolina, in accordance with federal/state law, scope of practice regulations or contract, the requirements are:

• Requires an active and current license as an LCSW, LCMHC, LPA, LMFT, or RN issued by the state of North Carolina.
• Requires a MS/MA in social work, counseling, or a related behavioral health field, or a degree in nursing.
• Requires three (3) years of experience providing care management, case management, or care coordination to individuals served by the child welfare system.

Preferred Skills, Capabilities, and Experiences:

• 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 strongly preferred.
• Experience serving the children and youth involved in Foster Care and Social Services is strongly preferred.
• 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.
• Travels to worksite and other locations as necessary.

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