CFSP Managed Care Coordinator - Buncombe County

Elevance Health•Fairview, NC

11d•Onsite

About The Position

The CFSP Managed Care Coordinator manages members’ individual service plans within the scope of the North Carolina Children and Families Specialty Plan (CFSP), as required by applicable state law and contract. The program partners with North Carolina DHHS to provide Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system with seamless, integrated, and coordinated care. Services include physical and behavioral health, pharmacy, intellectual and developmental disabilities services, long-term services and supports, unmet health-related resource needs, and integrated care management. This is a field-based role in Buncombe County, primarily serving Asheville. The coordinator travels to client sites or other designated locations and interacts with members, patients, or providers in person four to five days per week. Occasional office attendance may be required for meetings or training; colocation may require reporting to an office one to three days per week as needed. Candidates must live within a reasonable commuting distance of the posting location unless an accommodation is granted as required by law.

Requirements

Bachelor of Arts or Bachelor of Science degree and at least one year of experience working directly with people related to the specific program population or in other related community-based organizations, or an equivalent combination of education and experience.
Must reside in North Carolina.
Must be within a reasonable commuting distance of the posting location unless an accommodation is granted as required by law.

Nice To Haves

Bachelor of Arts or Bachelor of Science degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human services area.
Two years of experience working directly with individuals served by the child welfare system.
Ability to report to an office one to three days per week as needed if colocation is required.

Responsibilities

Provide integrated, whole-person care management under the CFSP Care Management model, coordinating physical health, behavioral health, intellectual and developmental disabilities services, long-term services and supports, pharmacy, and unmet health-related needs.
Provide trauma-informed care, recognizing the role of adverse childhood experiences and coordinating cross-agency support for members’ physical, behavioral, social, educational, and legal needs.
Collaborate with each member’s County Child Welfare Worker to align health care needs with permanency planning goals.
Coordinate care with multidisciplinary teams, including primary and behavioral health professionals, specialty providers, and child welfare stakeholders, with awareness of juvenile justice coordination.
Conduct telephonic or face-to-face assessments using predefined questions to identify, evaluate, coordinate, and manage members’ program needs.
Identify members with potential clinical health care needs using predefined tools and coordinate cases with clinical health care management and interdisciplinary teams.
Oversee members’ non-clinical needs when they have chronic illnesses, co-morbidities, or disabilities, supporting 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 may benefit from expanded services.
Travel to the worksite and other locations as necessary.