CFSP Managed Care Coordinator - Rutherford County

Elevance Health (Anthem); North Carolina; Vor Ort; USD 50.000 - 70.000; Vollzeit

Zusammenfassung

Elevance Health in North Carolina seeks a CFSP Managed Care Coordinator to manage member care plans in the NC CFSP program. This field-based role in Rutherford County requires travel to client sites and coordination with county welfare and health professionals to ensure integrated care for children and families.

The role emphasizes trauma-informed care, collaboration with county workers, and development of short- and long-term goals with members and families, with some office meetings as needed.

Qualifikationen

• Requires BA/BS degree with at least 1 year of experience working with the CFSP population or related community-based organizations.
• Preference for BA/BS in health, psychology, sociology, social work, nursing or related human services field.
• Two (2) years of experience working directly with individuals served by the child welfare system is preferred.
• Colocation is a possibility that could require reporting to office location 1–3 days per week as needed.
• Travels to worksite and other locations as needed.

Aufgaben

• Provide integrated whole-person Care Management under the CFSP Care Management model across physical health, behavioral health, I/DD, LTSS, pharmacy, and unmet health-related needs.
• Offer Trauma-Informed Care by recognizing ACEs and coordinating cross-agency care for children’s diverse needs.
• Collaborate with each Member's County Child Welfare Worker to align health care needs with permanency goals.
• Work with a multidisciplinary care team to coordinate care with primary care, behavioral health, specialty providers, and child welfare stakeholders.
• Conduct telephonic or face-to-face assessments to identify, evaluate, coordinate, and manage member program needs.
• Identify members with potential clinical health care needs and coordinate with an interdisciplinary team for care coordination support.
• Oversee non-clinical needs of members with chronic illnesses or disabilities for cost‑effective service utilization.
• Set short- and long-term goals with members, caregivers, families, and physicians.

Ausbildung

BA/BS degree

Jobbeschreibung

Anticipated End Date: 2026-11-20

Position Title:

CFSP Managed Care Coordinator - Rutherford County

Job Description:

CFSP Managed Care Coordinator

We are currently seeking people in the following counties and look forward to speaking with you! (Rutherford, Polk, Henderson, McDowell and Burke)

Location: Field: This field-based role in Rutherford County (Rutherfordton) , 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. These roles are county field-based and require you to interact with patients, members, or providers in person four to five days per week.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid‑enrolled infants, children, youth, young adults, and families served by the child welfare system so that they receive seamless, integrated, and coordinated health care. Within the Children and Families Specialty Plan (CFSP), and regardless of where a member lives, they will have access to the same basic benefits and services, including Physical health, Behavioral health, Pharmacy, Intellectual/Developmental Disabilities (I/DD) services, long term services and supports, Unmet health‑related resource needs, and Integrated care management. We envision North Carolina where all children and families thrive in safe, stable, and nurturing homes.

The CFSP Managed Care Coordinator is responsible for the overall management of the members' individual service plan within the scope of position in the NC CFSP Program, as required by applicable state law and contract.

How you will make an impact:

• Provide integrated whole-person Care Management under the CFSP Care Management model, including coordination across physical health, behavioral health, I/DD, LTSS, pharmacy, and unmet health‑related needs.
• Offer Trauma‑Informed Care by recognizing the role of ACEs in the CFSP population and coordinating cross‑agency care to support children's diverse needs, including physical, behavioral, social, educational, and legal aspects.
• Collaborate closely with each Member's County Child Welfare Worker to align health care needs with permanency planning goals.
• Work with a multidisciplinary care team, including primary health care and behavioral health professionals, specialty providers, and stakeholders in the child welfare system, to coordinate care (e.g., coordination involving juvenile justice awareness).
• Conduct telephonic or face‑to‑face assessments using predefined questions to identify, evaluate, coordinate, and manage member program needs.
• Identify members with potential clinical health care needs using predefined tools, coordinating their cases with clinical healthcare management and an interdisciplinary team for care coordination support.
• Oversee non‑clinical needs of members with chronic illnesses, co‑morbidities, or disabilities for cost‑effective and efficient service utilization.
• Set short‑and long‑term goals in collaboration with members, caregivers, families, natural supports, and physicians.
• Identify members who would benefit from expanded services.

Minimum Requirements

Requires BA/BS degree and a 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.

Preferred Skills, Capabilities, and Experiences:

• Must reside in North Carolina.
• BA/BS degree preferred in a field related to health, psychology, sociology, social work, nursing or another relevant human services area.
• Two (2) years of experience working directly with individuals served by the child welfare system is preferred.
• Colocation is a possibility that could require reporting to office location 1 -3 days per week as needed.
• Travels to worksite and other locations as needed.

Job Level:

Non‑Management Non‑Exempt

Job Family:

MED > Care Coord & Care Mgmt (Non‑Licensed)

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our membe