Managed Care Coordinator - Behavioral Health/Foster Care (BSW, MSW, or QMHP)
About The Position
The Managed Care Coordinator manages members’ individual service plans within the scope of the position and as required by applicable state law and contract. This field-based role primarily involves travel to client sites or designated locations, with occasional office attendance for meetings or training. Candidates should reside in Shenandoah County, Augusta County, or Harrisonburg, Virginia; alternate locations may be considered if they are within commuting distance of an office. Candidates outside a reasonable commuting distance will not be considered unless an accommodation is granted as required by law. The coordinator conducts telephonic or face-to-face history and program-needs assessments using predefined questions, identifies members with potential clinical healthcare needs using established tools and processes, and coordinates cases with clinical healthcare management and interdisciplinary teams. The work does not involve clinical judgment. The coordinator also manages members’ non-clinical needs, collaborates with members and their support networks to establish goals, and identifies members who could benefit from expanded services.
Requirements
- BA/BS degree.
- At least 1 year of experience working directly with people related to the specific program population or with other related community-based organizations, or an equivalent combination of education and experience.
- Must reside in Shenandoah County, Augusta County, or Harrisonburg, Virginia, or an alternate location within commuting distance of an office.
- Travel to the worksite and other locations as necessary.
Nice To Haves
- QMHP, MSW, or BSW degree.
- Experience with foster care.
- Behavioral or mental health experience.
- LTSS or DD waiver experience.
- Education and years and type of experience that meet applicable state law and contract requirements.
Responsibilities
- Conduct telephonic or face-to-face history and program-needs assessments using a tool with predefined questions.
- Identify members with potential clinical healthcare needs using designated tools and processes, and coordinate their cases with clinical healthcare management and interdisciplinary teams to provide care coordination support.
- Manage non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities to support cost-effective and efficient utilization of services.
- Establish short- and long-term goals in collaboration with members, caregivers, family, natural supports, and physicians.
- Identify members who could benefit from expanded services.
- Travel to the worksite and other locations as necessary.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution.
- 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) match.
- Life insurance.
- Wellness programs.
- Financial education resources.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
