CFSP Managed Care Coordinator - Alleghany County

Elevance Health•Sparta, NC

11d•Onsite

About The Position

The CFSP Managed Care Coordinator manages members’ individual service plans within the scope of the role in North Carolina’s Children and Families Specialty Plan (CFSP), as required by applicable state law and contract. The CFSP is a statewide Medicaid Plan developed with North Carolina DHHS to provide coordinated health care for Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system. Services include physical and 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 county field-based role serving Alleghany County, based in Sparta. Associates primarily work in the field, traveling to client sites or designated locations, with occasional office attendance for meetings or training. The role requires in-person interaction with patients, members, or providers four to five days per week. Candidates must live within a reasonable commuting distance of the posting location, unless an accommodation is granted as required by law. The coordinator travels to the worksite and other locations as necessary.

Requirements

Bachelor’s degree (BA/BS) and at least one year of experience working directly with people related to the specific program population or other related community-based organizations; alternatively, 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

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, intellectual and developmental disability 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.
Work with a multidisciplinary care team, including primary health care 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 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 in collaboration with members, caregivers, families, natural supports, and physicians.
Identify members who could benefit from expanded services.