CFSP Managed Care Coordinator - Alleghany County

Elevance Health • Sparta, NC

12d • Onsite

About The Position

The CFSP Managed Care Coordinator manages members’ individual service plans within the scope of the NC 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 care across physical health, behavioral health, intellectual/developmental disabilities, long-term services and supports, pharmacy, and unmet health-related needs.

This is a county field-based position in Alleghany County, based in Sparta. The coordinator primarily works in the field, traveling to client sites or designated locations, and interacts with members, patients, or providers in person four to five days per week. Occasional office attendance is required for meetings or training. Candidates must live in North Carolina and within 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 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, coordinating physical health, behavioral health, I/DD, LTSS, pharmacy, and unmet health-related needs.
• Use 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 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 healthcare 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 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 benefits
• Dental benefits
• Vision benefits
• Short- and long-term disability benefits
• 401(k) with match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level