Mindoula is seeking to hire a talented and experienced Case Manager for our Population Health Program in Raleigh, NC area to leverage their clinical judgment and experience to work with our members in a new partnership in the state.

The goal of the North Carolina Population Health program is to provide virtual and in-person care to patients with Severe Mental Illness (SMI) and Substance Use Disorder (SUD) who are medically complex and often struggle to navigate the behavioral health care system.

Our Case Manager will collaboratively manage our complex patients by increasing direct patient mental health care, removing barriers to care, addressing unmet needs, providing urgent and crisis care, and facilitating timely post-hospitalization support. The ideal candidate will have a passion for providing excellent care that is patient-centered and timely and thrives in a high-growth environment. They will guide members in the development of skills and/or strategies for managing problems and triggers to increase relapse prevention and reduce risk. The right Case Manager will enjoy serving patients as well as working with a group of exceptional colleagues to deliver meaningful outcomes for patients and for the company, leveraging their professional expertise to ensure success in their role.

How you'll contribute:

• Deliver community case management activities to develop, implement and grow the Population Health Program, including the following:
• Actively manage a caseload of attributed members with SMI/SUD across diverse populations, ranging from young adult to geriatric, to improve overall health and wellness and reduce avoidable utilization (e.g., ED/admissions/readmissions)
• Establish the members' behavioral health provider, and take responsibility for supporting and coordinating the mental and physical health care of patients on their assigned caseload
• Manage member care and progress for cases with multiple levels or risk focusing on behavioral health needs
• Use clinical judgment along with other data to evaluate and determine member acuity, as member needs change over time, to determine the appropriate care monitoring plan
• Oversee identified highly complex patients within caseload and ensure effective implementation of interventions
• Develop solutions to improve overall longitudinal health outcomes and reduce avoidable hospital and ED utilization
• Work within communities in Raleigh-Durham, NC and surrounding counties, to help implement this program and serve our members in an innovative, value-based contract
• Conduct meaningful telephonic outreach, and some in-person outreach within the community, as needed, to locate members for engagement
  
• Screen and assess members as well as provide education about behavioral health and substance use disorder, Mindoula's services, and drive member enrollment and engagement
• Assess members for risk, develop safety plans and respond within the parameters outlined within the safety plan, formulating and performing crisis intervention that ensures the safety of members as necessary
• Closely coordinate direct care by identifying providers, scheduling appointments, and following up to ensure attendance and fit

• In partnership with the member, create an individualized Service Plan using professional knowledge of the SMI and SUD population to guide engagement based on member diagnoses, screenings, and care gaps
• Support psychotropic medication management as prescribed by the longitudinal Mindoula direct care provider or other community providers, focusing on treatment adherence monitoring, side effects, and effectiveness
• Engage members after hospitalizations and facilitate timely medical follow up plans, ensuring quality of care goals are met. Contact members to remind them about upcoming appointments and/or missed appointments, building accountability
• Build measurable goals for members to develop skills and/or strategies for managing challenges and triggers to reduce hospital admissions/readmissions and use of the ER
• Support members in achieving their goals as outlined in their Service Plans, created with an emphasis on meeting behavioral health and medical needs, closing care gaps, and, as addressing social determinants of health, as identified
• Develop member capacity and skills to proactively self-manage their health and reduce over-utilization of unnecessary healthcare utilization
• Act as an advocate for members, and interact continuously with members, families, physician(s), and other providers utilizing clinical knowledge and expertise to reduce avoidable utilization (e.g., ED/admissions/readmissions)
• Develop and complete a relapse prevention self-management plan with patients who have achieved their treatment goals and are soon to be moved to a lower level of support
• Communicate compassionately with members, their families/caregivers, staff and treatment team, utilizing excellent interpersonal skills
• Respond immediately, yet calmly, to crisis situations and quickly build rapport with members
• Ensure all direct and in-direct activity with or in support of the member is accurately reflected in mMR case notes, entered within 24 hours after each event/activity
• Prepare and maintain all required records, reports, consents, and members' diagnostic records, maintaining the confidentiality of members at all times while producing high-quality documentation that enables the members to receive the best treatment possible
• Elevate critical incidents and information regarding any quality-of-care concerns
• Report hospital diversions, productivity, and other outcomes weekly
• Participate in staff meetings and individual meetings with the supervisor
• Perform other duties and special projects as assigned

What will make you successful:

• Ability and desire to work with diverse populations, ranging from young adult to geriatric populations
• Automatic orientation to plan, organize, manage time, and prioritize multiple tasks and assignments effectively
• Excellent communication skills - oral and written. Ability to clearly and accurately relay information to members, staff, and stakeholders
• Demonstrated ability to achieve high-performance goals and meet deadlines in a fast-paced environment
• Ability to work in a collaborative environment and effectively with others to set goals, resolve problems, and make decisions that enhance organizational effectiveness
• Results orientation to identify needs and takes independent action to implement change when and where it is needed
• Proven ability to handle confidential information with discretion, be adaptable to various competing demands, and demonstrate the highest level of customer/member service and response
• Positive openness to supervision and coaching, including recommendations for improved performance
• Ability to provide case management in routine and crisis situations
• Attention to detail and willingness to support innovation from the early build phase of a project through its successful completion
• Excellent computer skills and experience with Google Suite software and Microsoft Office software

Education & Experience:

• Master's Degree in psychology, social work, or other behavioral health disciplines from an accredited college or university
• Three or more years of relevant experience in the behavioral health field providing longitudinal case management, counseling, family dynamics care management, and/or crisis intervention,
• Knowledge of community resources, social determinants of health, mental health and/or substance use disorders/disabilities, trauma-informed care, recovery/resiliency-oriented services, benefits, and social issues for longitudinal support
• Knowledge of benefits and local resources to support a SMI and SUD commercial and Medicare Advantage-insured population

Travel:

• This position requires up to 50% travel (locally) and, therefore, requires the employee has reliable transportation

Schedule: Monday – Friday, 9-5 pm EST, with up to 20% evenings or weekends

Mindoula is a leading population health management company that scales the human connection through technology to address mind, body, and life challenges. Mindoula identifies, engages, and serves populations that might otherwise be overlooked or left behind and delivers tech-enabled, team-based, 24/7 support across the continuum of care.

Mindoula Health is committed to the principles of equal employment. We are committed to complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is our intent to maintain a work environment that is free of harassment, discrimination, or retaliation because of age, race, color, national origin, ancestry, religion, sex, gender identity, pregnancy (including childbirth, lactation, and related medical conditions), marital status, sexual orientation, gender identity, credit history, physical or mental disability, genetic information (including testing and characteristics), veteran status, uniformed service member status, or any other status protected by federal, state, or local laws.

Come be part of the solution!