Managed Care Coordinator (VA Foster Care Program)

Elevance Health•Charlottesville, VA

10d•$24 - $38•Hybrid

About The Position

The Managed Care Coordinator is responsible for the overall management of a member's individual service plan within the scope of the position, as required by applicable state law and contract. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Requirements

BA/BS degree
Minimum of 1 year of experience working directly with people related to the specific program population or other related community based organizations; or any combination of education and experience which would provide an equivalent background.
Must reside in one of the following locations: Harrisonburg City, Rockingham, Page County, Shenandoah, Luray Corridor, Augusta County, Staunton, Waynesboro, Charlottesville, Albemarle, Bedford, Botetourt, Rockbridge, Amherst, Nelson, Alleghany, Covington, Peninsula, Lynchburg, Appomattox, Campbell.

Nice To Haves

QMHP, MSW or BSW degree preferred.
Specific education and years and type of experience may be required based upon state law and contract requirements.
Travels to worksite and other locations as necessary.
Experience with Foster Care preferred
Behavior/Mental Health experience preferred
LTSS / DD waiver experience preferred.

Responsibilities

Performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's program needs.
Identifying members with potential clinical health care needs (including, but not limited to, potential for high risk complications) using tools and a pre-defined identification process, and coordinating those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
Managing the non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost-effective and efficient utilization of services.
Establishing short and long-term goals in collaboration with the member, caregivers, family, natural supports, and physicians.
Identifying members that would benefit from expanded services.