CFSP Managed Care Coordinator - Buncombe County

Elevance Health•Asheville, NC

10d•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 CFSP is a statewide Medicaid plan supporting Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system. It coordinates access to physical and behavioral health, pharmacy, intellectual and developmental disability services, long-term services and supports, health-related resources, and integrated care management. This is a county field-based position in Buncombe County, primarily serving the Asheville area. Coordinators interact with members, patients, or providers in person four to five days per week, travel to client sites or designated locations, and attend occasional office meetings or training. Colocation may require office reporting one to three days per week as needed. Candidates must live in North Carolina and within a reasonable commuting distance of the posting location, unless an accommodation is granted as required by law. The coordinator provides integrated, whole-person and trauma-informed care management, recognizing the impact of adverse childhood experiences and coordinating across agencies to address members’ physical, behavioral, social, educational, and legal needs. The role works closely with county child welfare workers, families, caregivers, natural supports, physicians, health care providers, and other stakeholders to coordinate services and align health care with permanency planning goals.

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 with 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 health-related field, 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.

Responsibilities

Provide integrated whole-person care management across physical health, behavioral health, intellectual and developmental disabilities, long-term services and supports, pharmacy, and unmet health-related needs.
Offer trauma-informed care and coordinate 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 a multidisciplinary team that includes primary care 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 member program needs.
Identify members with potential clinical health care needs using predefined tools and coordinate cases with clinical health care management and an interdisciplinary team.
Oversee non-clinical needs of members with chronic illnesses, co-morbidities, or disabilities to support cost-effective and efficient service utilization.
Set short- and long-term goals 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.