Managed Care Coordinator - Behavioral Health/Foster Care (BSW, MSW, or QMHP)

Elevance Health • Richmond, VA

3d • Hybrid

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 is a field-based role serving members in Virginia; associates travel to client sites or designated locations as needed, with occasional office attendance for meetings or training. Candidates must reside in the listed Virginia counties or locations, or within reasonable commuting distance of a posting location, subject to the stated accommodation policy.

The coordinator conducts telephonic or face-to-face history and program-needs assessments using predefined questions and tools. They identify members with potential healthcare needs and coordinate cases with clinical healthcare management and interdisciplinary teams for care-coordination support. The assessment and identification process does not involve clinical judgment. The role also addresses members’ non-clinical needs, supports efficient service utilization, sets goals collaboratively with members and their support networks, and identifies members who may benefit from expanded services.

Requirements

• BA/BS degree.
• At least 1 year of experience working directly with people in the specific program population or with related community-based organizations, or an equivalent combination of education and experience.
• Reside in the listed Virginia counties or within reasonable commuting distance of a posting location, subject to the stated policy.

Nice To Haves

• QMHP, MSW, or BSW degree.
• Experience with foster care.
• Behavioral or mental health experience.
• LTSS or DD waiver experience.

Responsibilities

• Manage members’ individual service plans within the scope of the position and applicable state law and contract.
• Conduct telephonic or face-to-face history and program-needs assessments using predefined questions and tools.
• Identify members with potential clinical healthcare needs, including potential high-risk complications, using defined tools and processes.
• Coordinate 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 service utilization.
• Establish short- and long-term goals collaboratively with members, caregivers, family, natural supports, and physicians.
• Identify members who may 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, dental, and vision benefits.
• Short- and long-term disability benefits.
• 401(k) matching.
• Life insurance.
• Wellness programs.
• Financial education resources.

What This Job Offers

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