We are currently seeking Integrated Health Consultants (Registered Nurse) to serve members in Mecklenburg, Wake, Durham, Cumberland and Johnston counties.
This position will allow the successful candidate to work a schedule which will include both onsite as well as remote work certain 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 those IHC II’s which are assigned to Acute Care Facilities, Emergency Departments and State Psychiatric Hospitals there will be active participation in discharge planning beginning with admission.
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
Complete Assessments and Planning
Utilize person-centered planning, motivational interviewing and assessments to gather information
Provide education and supports to members and/or legal guardians regarding 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, preferred crisis facilities, and medication allergies and preferences
Develop and update plans of care based off the needs identified in the assessments and complete the interventions identified as needed
Monitoring/Coordination
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
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
Required Education & Experience
Graduation from a school of nursing and two (2) years of full-time experience with the population served including experience with case management/discharge planning in one of the following settings: Acute care, Home care, LTC care, Physician Office or Managed Care.