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Special Programs Case Manager 1 – Complex Medical Clinical Care Advisor
Elevance Health. Manage Children and Families Specialty Plan integrated physical and behavioral health care management teams .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing integrated physical and behavioral health care for children and families, with a focus on developing comprehensive clinical programs and individualized treatment plans. Possesses strong knowledge of community-based services, cultural competency, and effective collaboration with stakeholders.
Highest-signal resume keywords
Clinical Program DevelopmentIntegrated Care ManagementBehavioral Health ExperienceLicensed Health ProfessionalCertified Case Manager
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical AssessmentCare Plan DevelopmentCase ManagementProcess ImprovementMedication ReconciliationDischarge PlanningService Delivery CoordinationComplex Medical Conditions ManagementCommunity Resource IdentificationHealth Needs Evaluation
Soft Skills
CollaborationMentoringCultural CompetencyCommunicationLeadership
Certifications & Qualifications
Active RN LicenseLCSW LicenseLMHC LicenseLPC LicenseLMFT LicenseClinical Psychologist LicenseCertified Case Manager Certification
Industry Keywords
Foster CareAdoption AssistanceIntellectual DisabilitiesDevelopmental DisabilitiesSocial Determinants of HealthManaged Care SettingCommunity-Based ServicesBehavioral HealthSubstance Abuse TreatmentLocal Departments of Social Services
About the role
Key responsibilities & impact- Manage Children and Families Specialty Plan integrated physical and behavioral health care management teams
- Develop, implement, and coordinate a comprehensive clinical program for youth in foster care and adoption assistance, including members with Intellectual & Developmental Disabilities and complex medical and behavioral health needs
- Manage overall healthcare costs, case management, and whole-person health
- Collaborate with families, foster parents, service teams, and other stakeholders to create and sustain individualized treatment plans
- Conduct assessments to identify individual needs
- Develop comprehensive care plans addressing assessment objectives and goals
- Support access to appropriate, quality, and cost-effective care and modify plans as needed
- Coordinate internal and external resources for integrated physical and behavioral whole-person care
- Coordinate social determinants of health and incorporate them into care planning
- Work closely with state agencies
- Maintain knowledge of the system of care philosophy and community-based services and supports
- Build partnerships with designated populations and families while addressing cultural and linguistic needs
- Evaluate health needs and identify services and resources with members and families
- Provide patient education, medication reconciliation, community resource identification, and follow-up care arrangements
- Facilitate health rounds with other clinical professionals
- Lead or work on specialty projects and initiatives
- Assist with process improvement activities
- Train and mentor staff
- Perform case and chart audits and ensure departmental compliance
- Serve as a member of the leadership team
Requirements
What you’ll need- North Carolina residency is required
- Requires MS/MA in social work, counseling, or a related behavioral health field, or a degree in nursing, or an equivalent combination of education and experience
- Minimum of 3 years of clinical experience in social work counseling with broad experience in complex psychiatric and substance abuse or substance abuse disorder treatment
- Requires an active, current, and valid license as an RN, LCSW, LMHC, LPC, LMFT, or Clinical Psychologist, as applicable by state law and scope of practice
- Must be licensed to practice as a health professional within the scope of licensure in applicable states or territory of the United States
- LCSW-A, LCMHC-A, and other associate-level licenses cannot be accommodated
- RN with Complex Medical and Long Term Services and Supports (LTSS) experience highly preferred
- Experience with children, youth, and families served by Local Departments of Social Services through Foster Care and Adoptive Assistance programs strongly preferred
- Certified Case Manager Certification strongly preferred
- Experience serving children and youth involved in Foster Care and Social Services strongly preferred
- Prior experience managing service delivery for children and youth with complex medical conditions strongly preferred
- Knowledge of resources, supports, services, and opportunities for safe community living for populations receiving in-reach and transition services, including Complex Medical and Behavioral Health, strongly preferred
- Service delivery coordination, discharge planning, or behavioral health experience in a managed care setting preferred
Benefits
Comp & perks- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) with employer match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Hybrid workforce strategy
- Professional and personal growth opportunities