For MCO Staff & Referral Partners
Specialized IDD and TBI Case Management
Serving 56 NC Counties
Covenant Case Management Services delivers CARF-accredited, NC DHHS-certified case management for individuals with Intellectual and Developmental Disabilities (IDD) and Traumatic Brain Injury (TBI) — with the clinical depth, geographic reach, and MCO coordination capacity to support complex placements efficiently.
Serving Tailored Plan and Standard Plan referrals across 56 North Carolina counties — with intake response within one business day.
The Placement Reality
Why IDD and TBI Placements Require a Different Kind of Provider
Care coordinators and discharge planners working with individuals who have IDD or TBI know the reality: this is not a population where a standard referral list works. Most community-based providers lack the clinical infrastructure to address the behavioral complexity, secondary diagnoses, and long-term support needs that define these individuals’ lives. The result is delayed discharges, failed placements, and clients cycling back through acute or institutional settings.
The documentation burden compounds the problem. MCO utilization management requires timely authorization support, service justification aligned with person-centered goals, and ongoing coordination that most providers cannot sustain. When a placement is made to an underprepared provider, it does not stay made.
CCMS was built specifically for this gap. Our team works exclusively with IDD and TBI populations — we do not generalize, and we do not dilute. Every care manager on our staff carries the training, the caseload structure, and the MCO-facing communication skills to make your referral stick.
Why Specialization Matters
Individuals with IDD and TBI face compounding barriers: limited provider capacity, complex authorization requirements, and co-occurring behavioral health needs that most general case managers are not equipped to navigate. Specialty-focused case management reduces emergency utilization and improves placement durability.
Key Term for Referral Partners
What Is a Tailored Plan?
North Carolina’s Medicaid Tailored Plans are specialized managed care organizations that serve members with the most complex behavioral health, IDD, and TBI needs. CCMS works with all NC Tailored Plans to coordinate prior authorizations, person-centered planning, and ongoing utilization review.
What We Provide
Services Designed for Complex Community Placement
Every service we offer is built around the clinical and coordination realities of IDD and TBI — not adapted from a general case management model.
Community-Based Supports
We coordinate access to community resources, habilitation services, and daily living supports that reinforce independence for individuals with IDD and TBI. Our care managers maintain active relationships with local providers to reduce gaps between authorization and service delivery.
Community Transition (CTI)
For individuals transitioning from institutional, inpatient, or residential settings, we provide structured transition planning and post-discharge support coordination. We work directly with facility discharge teams to align timelines, service authorizations, and receiving community supports before the transition date.
IDD Case Management
Our IDD case managers provide individualized planning, service coordination, and advocacy for people with intellectual and developmental disabilities across the lifespan. We are experienced with Innovations Waiver services and can coordinate with your team at every stage of the authorization cycle.
TBI Case Management
We specialize in the post-acute and long-term care management needs of individuals with traumatic brain injuries — including those with co-occurring behavioral health diagnoses, physical disabilities, and complex family systems. Our TBI case managers understand both the medical and functional dimensions of TBI recovery.
Crisis Prevention Planning
Every client we serve has a documented crisis prevention plan developed in coordination with their care team, family, and behavioral health providers. We monitor for early warning indicators and maintain a clear escalation pathway to avoid preventable emergency utilization.
MCO and Tailored Plan Coordination
We function as an extension of your coordination team. Our staff is trained in North Carolina’s Tailored Plan structure, Medicaid managed care requirements, and prior authorization workflows. We respond to MCO documentation requests promptly and maintain communication logs accessible for compliance review.
Geographic Coverage
Where We Work
CCMS serves individuals across 56 North Carolina counties, with active caseloads in the Piedmont, Western Piedmont, Charlotte Metro, Sandhills, Foothills, and surrounding regions. Our headquarters is in Albemarle, NC, and our care managers operate in-field across the service area — not from a call center.
For referral partners working with individuals in rural or underserved counties within our footprint, we offer a dedicated intake pathway to reduce wait time for placements with time-sensitive discharge needs.
Confirm Coverage Before You Refer
Contact us before submitting a referral to verify county coverage for your specific client. We confirm eligibility within the same business day.
How It Works
How to Submit a Referral to CCMS
Our referral process is designed around the realities of your workflow. We do not require a proprietary portal, and we do not route referrals through an automated queue. Every referral is handled by a member of our intake team.
Submit the Referral
Submit via our online referral form, by email to info@covenantcms.com, or by phone at (704) 780-4552. You will need the client’s name, date of birth, primary diagnosis, county of residence, current placement setting, and the name of the referring MCO or facility. You do not need full documentation to initiate contact.
Intake Response Within One Business Day
Our intake coordinator will contact you within one business day to confirm receipt, verify county coverage, and identify any documentation needed to proceed. For urgent discharge situations, flag your referral as time-sensitive and we will prioritize same-day contact.
Needs Assessment
A CCMS care manager will conduct an initial needs assessment with the individual and, where applicable, their family or legal guardian. This assessment aligns with person-centered planning requirements and informs the initial service authorization request.
Care Plan Activation
Upon completion of the needs assessment and service authorization confirmation, we activate the individualized care plan and begin scheduled contacts with the client and your coordination team. You will receive written confirmation of care plan initiation and the assigned care manager’s direct contact information.
Why Partners Choose CCMS
Trusted by the Professionals Who Make Placement Decisions
“CCMS consistently responds to our referrals faster than any other provider in our network. Their documentation is clean, their care managers are easy to reach, and their clients stay placed. That last part is what matters most to us.”
“We handle complex TBI discharges on a regular basis, and CCMS is one of a small number of providers we trust with our most challenging cases. They communicate proactively, they know the authorization process, and they follow through.”
Common Questions
Referral Partner FAQ
Answers to what care coordinators, discharge planners, and MCO staff ask most.
Ready to Refer?
When your client needs a provider who is ready — CCMS is.
When your client needs a provider with the clinical depth, the geographic reach, and the MCO coordination capacity to make a community placement work, we are ready to move.