CFSP Managed Care Coordinator - Wake County

CFSP Managed Care Coordinator Our ideal candidates will live in the following counties: Wake, Durham, Chatham, Johnston, Granville. Location: Field: This field-based role in Wake County , 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. These roles are county field-based and require you to interact with patients, members, or providers in person four to five days per week. 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 accommodation is granted as required by law. 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 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 children’s diverse needs, including physical, behavioral, social, educational, and legal aspects. Collaborate closely with each Member’s 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. Colocation is a possibility that could require reporting to office location 1–3 days per week as needed. Travels to worksite and other locations as necessary. 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. 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 View email address on click.appcast.io 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. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration. #J-18808-Ljbffr