Managed Care Coordinator - Behavioral Health/Foster Care (BSW, MSW, or QMHP)
About The Position
The Managed Care Coordinator is responsible for 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 position involves travel to client sites or designated locations, with occasional office attendance for meetings or training. Candidates should reside in Pittsylvania County, Danville, Henry County, or Martinsville, Virginia, or within commuting distance of an office; alternate locations may be considered. 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 assessments using predefined questions to identify, evaluate, coordinate, and manage members’ program needs. Using established tools and processes, the coordinator identifies members with potential clinical healthcare needs and coordinates their cases with clinical healthcare management and the interdisciplinary team. This process does not involve clinical judgment. The coordinator also manages members’ non-clinical needs, collaborates with members and their support networks to establish short- and long-term goals, and identifies members who may benefit from expanded services.
Requirements
- BA/BS degree.
- At least one year of experience working directly with people in the specific program population or in related community-based organizations, or an equivalent combination of education and experience.
- Residence in Pittsylvania County, Danville, Henry County, or Martinsville, Virginia, or within a reasonable commuting distance of an office.
Nice To Haves
- QMHP, MSW, or BSW degree.
- Foster Care experience.
- 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 laws and contracts.
- Conduct 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 using established tools and processes, and coordinate their cases with clinical healthcare management and the interdisciplinary team.
- Manage non-clinical needs of members with chronic illnesses, comorbidities, 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 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 plan.
- 401(k) contribution and matching.
- 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.
- Life insurance.
- Wellness programs.
- Financial education resources.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
