Field-Based Medicaid Care Manager

The Elevance Health Companies, Inc.; Winston-Salem (NC); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

merit increases

paid holidays

Paid Time Off

incentive bonus programs

medical

dental

vision

short and long term disability

401(k) +match

stock purchase plan

life insurance

wellness programs

financial education resources

Job summary

Elevance Health is hiring a CFSP Managed Care Coordinator to manage members' individual service plans within the NC CFSP program. The role involves coordinating physical health, behavioral health, I/DD, LTSS, and pharmaceutical services while engaging with county child welfare workers and multidisciplinary teams.

This field-based position in Rutherford County requires in-person interaction with patients, families, and providers, with occasional office meetings and travel across NC.

Qualifications

• 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.

Responsibilities

• Provide integrated whole-person Care Management under the CFSP Care Management model, coordinating across physical health, behavioral health, I/DD, LTSS, pharmacy, and unmet health-related needs.
• Offer Trauma-Informed Care by recognizing ACEs in CFSP population and coordinating cross-agency care to support children’s 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 for members (e.g., juvenile justice awareness).
• Conduct telephonic or face-to-face assessments to identify, evaluate, and manage member program needs.
• Identify members with potential clinical health care needs and coordinate their cases with clinical healthcare management and an interdisciplinary team.
• Oversee non-clinical needs of members with chronic illnesses, co-morbidities, or disabilities for cost-effective service utilization.
• Set short- and long-term goals with members, caregivers, families, and physicians.
• Identify members who would benefit from expanded services.

Skills

Care Management

Trauma-Informed Care

Cross-Agency Coordination

Interdisciplinary Collaboration

Assessments

Field-Based/Travel

Education

BA/BS degree

Job description

Elevance Health is hiring a CFSP Managed Care Coordinator to manage members' individual service plans within the NC CFSP program. The role involves coordinating physical health, behavioral health, I/DD, LTSS, and pharmaceutical services while engaging with county child welfare workers and multidisciplinary teams.

This field-based position in Rutherford County requires in-person interaction with patients, families, and providers, with occasional office meetings and travel across NC.