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 in accordance with applicable state law and contract requirements. This field-based role involves working directly with members at client sites or other designated locations, with occasional office attendance for meetings or training. The candidate should reside in Pittsylvania County, Danville, Henry County, or Martinsville, Virginia; alternate locations may be considered if within commuting distance of an office. The coordinator performs telephonic or face-to-face assessments using predefined questions to identify, evaluate, coordinate, and manage members’ program needs. The role identifies members with potential clinical healthcare needs and coordinates their cases with clinical healthcare management and interdisciplinary teams. It also supports members with non-clinical needs, helps establish goals with members and their support networks, and identifies members who may benefit from expanded services. The process does not involve clinical judgment.
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.
Nice To Haves
- QMHP, MSW, or BSW degree.
- Experience with foster care.
- Behavioral or mental health experience.
- LTSS or DD waiver experience.
- Specific education and years and type of experience may be required based on state law and contract requirements.
Responsibilities
- Manage members’ individual service plans within the scope of the position and applicable state law and contract requirements.
- Perform telephonic or face-to-face history and program needs assessments using predefined questions.
- Identify, evaluate, coordinate, and manage members’ program needs.
- Identify members with potential clinical healthcare needs and coordinate their cases with clinical healthcare management and interdisciplinary teams.
- Coordinate support for members with non-clinical needs, chronic illnesses, co-morbidities, and/or disabilities to promote cost-effective and efficient service utilization.
- Establish short- and long-term goals in collaboration 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.
- Incentive and recognition programs.
- Equity stock purchase.
- 401(k) contribution.
- Merit increases.
- Paid holidays.
- Paid Time Off.
- Incentive bonus programs.
- Medical, dental, and vision benefits.
- Short- and long-term disability benefits.
- 401(k) with match.
- 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
