NC Innovations Waiver Qualified professional(QP)

NC Innovations Waiver Qualified professional(QP) Blessing Care Services, LLC Raleigh, NC Job Details Contract $25.00 - $27.88 an hour 1 day ago Benefits Professional development assistance Qualifications Teamwork Physiology knowledge HIPAA Full Job Description Overview Join our dedicated team as an NC Innovations Waiver Qualified Professional (QP), where you will play a vital role in coordinating and managing community-based services for individuals with complex needs. This position offers an exciting opportunity to make a meaningful difference in the lives of those requiring specialized support, ensuring they receive personalized, compliant, and effective care. As a QP, you will leverage your extensive knowledge of healthcare systems, behavioral health, and patient-centered planning to facilitate seamless service delivery within the Medicaid waiver program. Your energetic approach and commitment to excellence will help empower individuals to achieve their highest level of independence and well-being. Responsibilities Conduct comprehensive assessments of individuals' needs, including medical, behavioral health, social, and functional evaluations, ensuring accurate and thorough documentation. Develop individualized service plans that align with Medicaid waiver requirements, incorporating input from clients, families, and interdisciplinary teams. Coordinate with healthcare providers, social workers, case managers, and community agencies to facilitate access to appropriate services such as outpatient care, inpatient hospitalization, post-acute care, or outpatient clinics. Ensure compliance with HIPAA regulations and maintain confidentiality of all medical records and patient information throughout the case management process. Oversee utilization management by reviewing diagnostic evaluations, discharge planning documents, and medical records to authorize necessary services while optimizing resource use. Provide patient service support through intake procedures, eligibility verification, and ongoing case management activities that promote positive health outcomes. Engage in diagnostic evaluation and behavioral health assessments for patients across settings such as hospitals (including Level I Trauma Centers), PICUs (Pediatric Intensive Care Units), or outpatient clinics. Facilitate discharge planning by collaborating with hospital staff—especially those experienced in acute care, ICU settings, or emergency medicine—to ensure smooth transitions from inpatient to community-based services. Participate in managed care activities by monitoring patient progress and adjusting plans as needed to meet evolving healthcare needs. Experience Proven experience working within hospital environments such as Level II trauma centers or Level I Trauma Centers is highly preferred. Strong background in acute care settings including ICU experience or emergency medicine enhances your ability to assess complex cases effectively. Demonstrated familiarity with hospital medicine practices, behavioral health services, mental health counseling, addiction counseling or social work is essential. Experience with pediatric populations in settings like PICUs or outpatient clinics adds valuable insight into diverse patient needs. Knowledge of physiology principles, patient assessment techniques, medical terminology, and diagnostic evaluation methods is critical for success in this role. Prior involvement in discharge planning, case management or utilization management within inpatient or post-acute care environments is highly advantageous. Familiarity with managed care processes and outpatient clinic operations supports comprehensive service coordination for clients across various healthcare settings. This dynamic role offers the chance to be at the forefront of community-based healthcare delivery—empowering individuals through compassionate support and expert guidance while working within a collaborative team environment committed to excellence in patient care.

Pay:

$25.00 - $27.88 per hour

Benefits:

Professional development assistance People with a criminal record are encouraged to apply

Work Location:

Hybrid remote in Raleigh, NC 27603