Nurse Care Manager - North Carolina - Virtual Care
About Quartet Health
Quartet is a purpose driven value-based behavioral healthcare company, building the nation’s leading behavioral health home. We deliver integrated care and better outcomes to improve the health of communities across America. Quartet is a trusted partner of health insurance plans, health systems, community behavioral health centers, certified community behavioral health clinics, and federally qualified health centers in 36 states across the country. We identify people in need of care and connect them directly to high quality behavioral care providers, including Quartet’s own medical group.
At Quartet, our values guide the way that we work together, starting with our commitment to putting patients first, and our shared focus on collaboration and innovation, so that we – together – can improve lives, one person at a time.
Quartet is backed by top investors like Oak HC/FT, GV (formerly Google Ventures), F-Prime Capital Partners, Polaris Partners, Deerfield Management, Centene Corporation, Independence Health Group, and Echo Health Ventures.
We're proud to offer the following benefits to all clinicians:
- Competitive compensation
- 100% cost coverage for all required licensing/credentialing fees
- IT equipment and support
- Mental health benefits via our EAP, with up to 5 free counseling sessions per concern
We offer additional benefits to our team members working full time:
- A generous accrued PTO policy
- Ten paid holidays each year
- Robust medical, dental and vision insurance plans
- A 401(k) plan with employer match
- 100% employer-paid life insurance, short-term and long-term disability insurance
- Annual continuing education unit (CEU) budget
- Up to 12 weeks of paid maternity leave
The Behavioral Health Nurse Care Manager works to assess, evaluate, and support members who are challenged by both severe mental illness and complex medical situations. The Behavioral Health Care Manager follows established guidelines and procedures and collaborates with other departments. They will work as part of a multidisciplinary team that assesses, facilitates, plans, and coordinates an integrated delivery of care across the continuum. The goal of the Behavioral Health Care Manager is to support members to achieve or maintain optimal health in both mind and body.
The Behavioral Health Care Manager employs their clinical judgment with individualized strategies to manage a member's physical, environmental and psycho-social health issues. The Behavioral Health Care Manager monitors members’ progress towards desired outcomes and helps to ensure the member receives quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
By continuously monitoring patient care, the Behavioral Health Care Manager conducts regular assessments and identifies and resolves barriers that hinder effective care. The Behavioral Health Care Manager will create and update member care plans and participate in the Interdisciplinary Care Team as needed.
- Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member’s health or psychosocial wellness, and triggers from the HRA
- Develops and implements a care management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member’s support network to address the member needs and goals.
- Conducts telephonic outreach as needed
- Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventional achievement, and suggest changes accordingly.
- Maintains ongoing member case load for regular outreach management
- Promotes integrations of services for members including behavioral health care and long -term services and supports to enhance the continuity of care for Troy members.
- Facilitates interdisciplinary care team meetings and informal ICT collaboration.
- Uses motivational interviewing to educate, support, and motivate change during member contacts.
- Assesses for barriers to care, provides care coordination and assistance to members to address concerns
- Collaborates with other care managers/supervisors as needed
- Participates in CM and company wide meetings as directed.
- Current, unrestricted NC RN license or Compact License Preferred.
- Previous Behavioral Health Experience
- Minimum 2 years experience required with Dual Special Needs Plans (D-SNP)
- Certified Case Manager (CCM), preferred
- Basic understanding of insurance products, benefits, coverage limitations, laws and regulations as it applies to the health plan.
- Proficient in Google Suite as well as ability to work with multiple applications
- Strong counseling or customer service background and can implement functional treatment plans
- Experience in managing members with both Medical and Behavioral Health needs and/or Substance Abuse needs.
Have someone to refer? Email firstname.lastname@example.org to submit their details to us.