CFSP Managed Care Coordinator - Forsyth County

Elevance Health•Greensboro, NC

11d•Onsite

About The Position

The CFSP Managed Care Coordinator manages members’ individual service plans within the scope of the role and in accordance with applicable state law and contract requirements for North Carolina’s Children and Families Specialty Plan (CFSP). The CFSP is a statewide Medicaid plan serving Medicaid-enrolled infants, children, youth, young adults, and families involved with the child welfare system. It coordinates physical health, behavioral health, pharmacy, intellectual and developmental disability services, long-term services and supports, unmet health-related resource needs, and integrated care management. This is a field-based position in Forsyth County, centered in Winston-Salem. The coordinator primarily works in the field and interacts with members, patients, or providers in person four to five days per week, with occasional office attendance for meetings or training. Colocation may require reporting to an office one to three days per week as needed. The role requires travel to worksites and other locations. Candidates must live in North Carolina and be within 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 in the specific program population or in related community-based organizations, or an equivalent combination of education and experience.
Must reside in North Carolina.
Must be able to travel to the worksite and other locations as necessary.

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.
Colocation and office reporting one to three days per week may be required as needed.

Responsibilities

Provide integrated, whole-person care management under the CFSP Care Management model, coordinating physical health, behavioral health, I/DD, LTSS, pharmacy, and unmet health-related needs.
Apply 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.
Work with a multidisciplinary care team—including primary health care and behavioral health professionals, specialty providers, and child welfare stakeholders—to coordinate care, with awareness of juvenile justice coordination where relevant.
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.
Oversee members’ non-clinical needs when they have chronic illnesses, co-morbidities, or disabilities to support 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 worksites and other locations as necessary.