CFSP Managed Care Coordinator - Wake County

Overview CFSP Managed Care Coordinator Location: Field-based role serving Wake County with travel to client sites or designated locations; office attendance for meetings or training as needed. Roles are county field-based and require interaction with patients, members, or providers in person four to five days per week. Our ideal candidates will reside in the following counties: Wake, Durham, Chatham, Johnston and Granville. Hybrid/virtual work policies apply; candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an 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), members have access to physical health, behavioral health, Pharmacy, I/DD services, LTSS, unmet health-related resource needs, and integrated care management. We envision NC where all children and families thrive in safe, stable, and nurturing homes. Responsibilities Provide integrated whole-person Care Management under the CFSP Care Management model, coordinating 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 (physical, behavioral, social, educational, and legal aspects). Collaborate 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 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 and coordinate their cases with clinical health care 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 providing an equivalent background. Preferred Skills, Capabilities, And Experiences Must reside in North Carolina. BA/BS degree preferred in health, psychology, sociology, social work, nursing, or another relevant human services field. 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 an office location 1–3 days per week as needed. Travel to worksites and other locations as necessary. Affirmation regarding agency recruitment: Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes remain the property of Elevance Health. EEO and Compliance Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender identity or expression, marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status protected by applicable laws. Some roles may require vaccination against COVID-19 and Influenza per policy. Applicants requiring accommodation may contact Elevance Health support. Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws. #J-18808-Ljbffr Elevance Health