CFSP Managed Care Coordinator - Guilford County

Elevance Health•Greensboro, NC

11d•Onsite

About The Position

The CFSP Managed Care Coordinator is responsible for overall management of 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. Elevance Health is partnering with North Carolina DHHS on a statewide Medicaid plan supporting Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system, with coordinated access to physical health, behavioral health, pharmacy, I/DD services, long-term services and supports, unmet health-related resource needs, and integrated care management. This is a field-based role in Guilford County, primarily serving Greensboro. The coordinator travels to client sites or designated locations and interacts in person with patients, members, or providers 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. Candidates must live within a reasonable commuting distance of the posting location unless an accommodation is granted as required by law.

Requirements

BA/BS degree and at least one year of experience working directly with people related to the specific program population or other related community-based organizations, or an equivalent combination of education and experience.
Must reside in North Carolina.
Ability to travel to worksites 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 children’s physical, behavioral, social, educational, and legal needs.
Collaborate with each member’s County Child Welfare Worker to align healthcare needs with permanency planning goals.
Work with a multidisciplinary care team, including primary 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 member program needs.
Identify members with potential clinical healthcare needs using predefined tools and coordinate cases with clinical healthcare 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.