We are currently seeking Integrated Health Consultants Nurse Consultant to serve members in Mecklenburg, Wake, Durham, Cumberland, Johnston and Orange counties.
This position will allow the successful candidate to work a schedule which will include both onsite as well as remote work four days of the week as approved by their supervisor.
The Integrated Health Consultant II (IHCII) provides an episodic and/or consultative role as part of the member’s multidisciplinary care team (MCT) when member physical and/or behavioral health needs are identified and warrant subject matter expertise or the member is transitioning from facility-based care. These consultants offer on-demand recommendations, complete assessments, provide education within their scope of licensure, and escalate review of complex cases to the Chief Medical Officer, Deputy Chief Medical Officer, Associate Medical Directors, and/or Pharmacists as necessary, in order to optimize health outcomes for the member.
For IHC II’s who are assigned to Acute Care Facilities, Emergency Departments and State Psychiatric Hospitals there will be active participation in discharge planning beginning with admission.
For IHC II RN’s and OT’s who are assigned to Complex Care Management, this position will require regular visits with members in Adult Care Homes and with members living in the community, resulting in significant travel.
Responsibilities & Duties
Provide Care Team Support
Support members transitioning from institutional care settings to community-based care.
Provide subject matter expertise, within scope, regarding member’s physical and/or behavioral health to support the development and delivery of a whole person approach to Care Management
Work collaboratively with other Alliance staff, behavioral health providers, primary care physicians, specialty care providers and other community partners and stakeholders to support members in their home communities.
Complete Assessments and Planning
Utilize person-centered planning, motivational interviewing and assessments to gather information
Perform assessments and support for members that are medically fragile or have significant health conditions, have a mental health condition, substance use condition, or co-occurring intellectual or developmental disability.
In the Transition and Housing setting, staff will also assess and record member’s activities and progress.
Provide education and supports to members and/or legal guardians regarding self-care strategies, their rights and responsibilities, available treatment options, provider network availability and payor requirements that may impact service access or maintenance
Educate team members about impact of member’s health conditions on service engagement, clinical outcomes, and prognosis for change
Actively collaborate with member and care team members to ensure care plan accurately reflects the individual’s clinical needs and desired life goals
Update Assessments and plans of care as needed
Provide education about advanced directives, preferred natural support and physical health contacts whom the member identifies, and preferred crisis facilities
Provide medication reconciliation and education
Develop and update plans of care based off the needs identified in the assessments and complete the interventions identified as needed
Review member’s medical history and identify specific goals and types of activities that will be used to help member work to help work towards those specific goals.
Proactively works with the member’s multidisciplinary care team to identify gaps in services and intervenes to ensure that the member is receiving the appropriate level of care.
Complex Care Management OT staff may evaluate a member’s home or workplace and based on member’s needs, may identify needed improvements and/or special durable medical equipment and instruct member’s on how to use this equipment.
Monitoring/Coordination
Appropriately escalate high risk/high visibility and/or complex barriers/needs members who may have difficulty transitioning out of the facility in a timely manner to supervisors. High risk can involve Health and Safety of a member, staff, or organizational risk
Review cases with clinical complexity with direct supervisor, peer clinical review cohort, and utilization management care managers and medical management leadership as needed.
Obtain information releases that will improve care management activities on behalf of the member and reports care quality concerns to Quality Management as needed
Documentation
Ensure all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency, and Medicaid requirements
Follow administrative procedures and effectively manages caseload
Data
Review, validate and interpret risk stratification data and population health groups and recommends changes or adjustments to care management approach as needed
Utilize data to analyze needs of the members we serve, guide staff training development, identify resource needs and consistency of workflow implementation across disciplines
Minimum Requirements
Education & Experience
For Nurse consultative role and Complex Care Manager-Registered Nurse
Graduation from a school of nursing and two years of full-time experience
Valid NC Driver License
RN
Knowledge, Skills, & Abilities
A demonstrated Knowledge of the assessment and treatment of mental health, substance abuse, intellectual and developmental disabilities,
Knowledge of legal, waiver, accreditation standards and program practices/requirements.
Knowledge of the Alliance Health service benefit plans and network providers.
Person Centered Thinking/planning
The employee must be detail oriented,
Ability to independently organize multiple tasks, priorities, and to effectively manage an assigned caseload under pressure of deadlines.
Exceptional interpersonal skills, highly effective communication ability,
Ability to make prompt independent decisions based upon relevant facts and established processes.
Problem solving, negotiation and conflict resolution skills
Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) is required
Salary Range
$56,132.63 to $96,630.87
