CFSP Managed Care Coordinator - Rockingham County

Elevance Health•Eden, NC

11d•Hybrid

About The Position

The CFSP Managed Care Coordinator manages members’ individual service plans within the scope of the position and in accordance with applicable state law and contract. The role supports the North Carolina Children and Families Specialty Plan (CFSP), a Medicaid plan for infants, children, youth, young adults, and families served by the child welfare system. The plan provides integrated access to physical and behavioral health, pharmacy, intellectual and developmental disability services, long-term services and supports, assistance with unmet health-related resource needs, and integrated care management. This is a county field-based role in Rockingham County, based in Wentworth. Associates primarily work in the field and interact with patients, members, 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 position requires travel to worksites and other locations. Candidates must be within a reasonable commuting distance of the posting location unless an accommodation is granted as required by law.

Requirements

A BA/BS 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.
Ability to travel to the worksite and other locations as necessary.

Nice To Haves

BA/BS 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.

Responsibilities

Provide integrated, whole-person care management under the CFSP Care Management model across physical health, behavioral health, I/DD, LTSS, 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.
Work with multidisciplinary care teams, including primary and behavioral health professionals, specialty providers, and child welfare system stakeholders, to coordinate care.
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 non-clinical needs of members with chronic illnesses, comorbidities, 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.