Managed Care Coordinator

Anticipated End Date :

Position Title :

Managed Care Coordinator

Job Description :

CFSP Managed Care Coordinator

We are currently seeking people in the following counties and look forward to speaking with you! (Alexander Alleghany Watauga Cherokee Clay Graham and Transylvania)

Location : Field : This field-based role in Alexander County (Taylorsville) enables associates to primarily operate in the field traveling to client sites or designated locations as their role requires with occasional office attendance for meetings or training. This approach ensures flexibility responsiveness to client needs and direct hands-on engagement.

Please note that per our policy on hybrid / virtual work candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

These roles are statewide field-based and requires you to interact with patients members or providers in person four to five days per week.

We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid-enrolled infants children youth young adults and families served by the child welfare system so that they receive seamless integrated and coordinated health care. Within the Children and Families Specialty Plan (CFSP) and regardless of where a member lives they will have access to the same basic benefits and services including Physical health Behavioral health Pharmacy Intellectual / Developmental Disabilities (I / DD) services long term services and supports Unmet health-related resource needs and Integrated care management. We envision a North Carolina where all children and families thrive in safe stable and nurturing homes.

The CFSP Managed Care Coordinator is responsible for the overall management of the members individual service plan within the scope of position in the NC CFSP Program as required by applicable state law and contract.

How you will make an impact :

Provide integrated whole-person Care Management under the CFSP Care Management model including coordination across physical health behavioral health I / DD LTSS pharmacy and unmet health-related needs.

Offer Trauma-Informed Care by recognizing the role of ACEs in the CFSP population and coordinating cross-agency care to support childrens diverse needs including physical behavioral social educational and legal aspects.

Collaborate closely with each Members County Child Welfare Worker to align health care needs with permanency planning goals.

Work with a multidisciplinary care team including primary health care and behavioral health professionals specialty providers and stakeholders in the child welfare system to coordinate care (e.g. coordination involving juvenile justice awareness).

Conduct telephonic or face-to-face assessments using predefined questions to identify evaluate coordinate and manage member program needs.

Identify members with potential clinical health care needs using predefined tools coordinating their cases with clinical healthcare management and an interdisciplinary team for care coordination support.

Oversee non-clinical needs of members with chronic illnesses co-morbidities or disabilities for cost-effective and efficient service utilization.

Set short- and long-term goals in collaboration with members caregivers families natural supports and physicians.

Identify members who would benefit from expanded services.

Minimum Requirements

Requires BA / BS degree and a minimum of 1 year of experience working directly with people related to the specific program population or other related community based organizations; or any combination of education and experience which would provide an equivalent background.

Preferred Skills Capabilities and Experiences :

Must reside in North Carolina.

BA / BS degree preferred in a field related to health psychology sociology social work nursing or another relevant human services area.

Two (2) years of experience working directly with individuals served by the child welfare system is preferred.

Travels to worksite and other locations as necessary.

Job Level :

Non-Management Non-Exempt

Workshift : Job Family :

MED >

Care Coord & Care Mgmt (Non-Licensed)

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes including those submitted to hiring managers are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy power our business outcomes and drive our shared success - for our consumers our associates our communities and our business.

We offer a range of market-competitive total rewards that include merit increases paid holidays Paid Time Off and incentive bonus programs (unless covered by a collective bargaining agreement) medical dental vision short and long term disability benefits 401(k) match stock purchase plan life insurance wellness programs and financial education resources to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager associates are required to work at an Elevance Health location at least once per week and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age citizenship status color creed disability ethnicity genetic information gender (including gender identity and gender expression) marital status national origin race religion sex sexual orientation veteran status or any other status or condition protected by applicable federal state or local laws. Applicants who require accommodation to participate in the job application process may contact for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal state and local laws including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Required Experience :

IC

Key Skills

Senior Care,Hoyer Lift,Medical office experience,Dementia Care,Home Care,Nursing,Alzheimers Care,Administrative Experience,Meal Preparation,Medication Administration,Memory Care,Tube Feeding

Employment Type : Full-Time

Experience : years

Vacancy : 1