CFSP Managed Care Coordinator - Nash County
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 CFSP is a statewide Medicaid plan intended to provide coordinated health care to Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system. Covered 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 county field-based role serves Nash County, North Carolina, and requires in-person interaction with patients, members, or providers four to five days per week, with occasional office attendance for meetings or training. The coordinator provides integrated, trauma-informed care management and works with members, families, caregivers, county child welfare workers, clinicians, providers, and other stakeholders to coordinate care and support members’ needs.
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 able 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 across physical health, behavioral health, intellectual and developmental disabilities, 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 multidisciplinary care teams, including primary 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, 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.
Benefits
- Merit increases
- Paid holidays
- Paid time off
- Incentive bonus programs, unless covered by a collective bargaining agreement
- Medical insurance
- Dental insurance
- Vision insurance
- Short- and long-term disability benefits
- 401(k) with matching
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
