CFSP Managed Care Coordinator - Guilford County

Elevance Health•Greensboro, 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 role provides integrated, whole-person care management for Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system, coordinating physical health, behavioral health, intellectual and developmental disability services, long-term services and supports, pharmacy, and unmet health-related needs. This is a county field-based position in Guilford County, based in Greensboro. The coordinator primarily works in the field, traveling to client sites or other designated locations and interacting with members, patients, or providers in person four to five days per week. Occasional office attendance is required for meetings or training, and colocation may require reporting to an office one to three days per week as needed. Candidates must live in North Carolina and be within a reasonable commuting distance of the posting location, unless an accommodation is granted as required by law. The coordinator provides trauma-informed care, recognizes the role of adverse childhood experiences, and works across agencies to address children’s physical, behavioral, social, educational, and legal needs. The role collaborates with county child welfare workers, families, caregivers, providers, and multidisciplinary care teams to coordinate services and align health care needs with permanency planning goals.

Requirements

Bachelor’s degree or equivalent combination of education and experience.
At least one year of experience working directly with people related to the specific program population or with other related community-based organizations.
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.
For certain patient/member-facing roles, new candidates must become vaccinated against COVID-19 and influenza unless they provide an acceptable explanation.

Nice To Haves

Bachelor’s 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, coordinating physical health, behavioral health, I/DD, LTSS, pharmacy, and unmet health-related needs.
Provide 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.
Work with multidisciplinary care teams, including primary health care and behavioral health professionals, specialty providers, and child welfare stakeholders, to coordinate care.
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 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 would benefit from expanded services.
Travel to the worksite and other locations as necessary.