Managed Care Coordinator - Region 3

The Judge Group; Durham (NC); On-site; USD 42,000 - 56,000; Full time

Job summary

The Judge Group is seeking a Field Care Coordinator / Community Health Worker to support members with chronic conditions by coordinating services, assessing program eligibility, and guiding access to community and healthcare resources. This non-clinical role emphasizes collaboration with families, providers, and community partners.

Responsibilities include developing Individual Service Plans, performing assessments, identifying barriers, and promoting cost-conscious utilization of benefits and

Qualifications

• Bachelor’s degree in a related field (healthcare, public health, social services, human services, psychology, sociology, community health, or similar).
• At least one year of direct experience with the relevant program population or related community-based organization.
• Experience with individuals who have chronic illnesses, disabilities, or complex social needs.
• Ability to conduct member assessments using structured tools and coordinate follow-up activities.
• Strong communication, organization, documentation, and time-management skills.

Responsibilities

• Manage and coordinate assigned members’ Individual Service Plans within legal and program requirements.
• Conduct telephonic and in-person member history, needs, and program assessments using standardized tools.
• Build collaborative relationships with members, caregivers, family, physicians, and community partners.
• Identify barriers affecting access to services and follow-through with care recommendations.
• Coordinate non-clinical services and community resources for members with chronic conditions.

Skills

Communication skills

Relationship-building

Organization

Documentation

Time-management

MS Office

Electronic documentation systems

Independent field work

Travel readiness

Education

Bachelor's degree in a related field

Tools

MS Office Suite

Electronic documentation systems

Job description

Field Care Coordinator / Community Health Worker

Schedule: Monday–Friday, 8:00 AM–5:00 PM, with occasional work outside of standard business hours as needed.

Work Arrangement: Field-based; candidates must be comfortable spending approximately 4–5 days per week in person with members, patients, providers, and community partners. Regular local travel to member homes, provider offices, worksites, and other community locations is required.

Position Summary

The Field Care Coordinator supports members with chronic conditions, disabilities, co-morbidities, and other complex non-clinical needs by coordinating services, assessing program eligibility and needs, and helping members access appropriate community and healthcare resources.

This role is responsible for managing each assigned member’s Individual Service Plan in accordance with applicable state regulations, program requirements, and contractual guidelines. The Care Coordinator conducts telephonic and face-to-face assessments, collaborates with members and their support systems, identifies barriers to care, and coordinates non-clinical services to promote effective, efficient, and cost-conscious utilization of available benefits and resources.

This is a non-clinical role. While the position may identify members who appear to have potential healthcare needs or may be at risk for complications, clinical concerns are coordinated with the appropriate clinical healthcare management and interdisciplinary care team. The role does not require independent clinical judgment.

Key Responsibilities

• Manage and coordinate assigned members’ Individual Service Plans within the scope of the role and in compliance with applicable state law, health-plan requirements, and program contracts.
• Conduct telephonic and in-person member history, needs, and program assessments using standardized tools and predefined assessment questions.
• Build collaborative relationships with members, caregivers, family members, physicians, natural supports, providers, and community-based organizations.
• Identify non-clinical barriers that may affect a member’s ability to access services, maintain stability, or follow through with care recommendations.
• Support members with chronic illnesses, co-morbidities, disabilities, and complex social needs by coordinating appropriate non-clinical services and community resources.
• Develop short- and long-term goals with members and their care teams, incorporating member preferences, caregiver input, and available support systems.
• Identify members who may benefit from expanded services, additional benefits, community programs, or enhanced care-management support.
• Use established identification tools and processes to recognize potential healthcare needs or indicators of high-risk complications.
• Refer or coordinate identified clinical concerns with clinical healthcare management staff and interdisciplinary team members, following defined escalation procedures.
• Facilitate access to community resources, including social-support services, transportation, housing-related resources, food assistance, behavioral-health support, home- and community based services, and other applicable programs.
• Maintain accurate, timely, and complete documentation of assessments, service plans, interventions, referrals, member contacts, and care-coordination activities.
• Promote efficient and cost-effective utilization of covered services while supporting member choice, safety, independence, and quality of life.
• Travel regularlly throughout the assigned territory to meet with members, providers, and community partners in person.
• Participate in team meetings, case reviews, trainings, and interdisciplinary care-planning discussions.
• Perform other duties as assigned based on program, state, and contractual requirements.

Required Qualifications

• Bachelor’s degree in a related field, such as healthcare, public health, social services, human services, psychology, sociology, community health, or a similar discipline.
• At least one year of experience working directly with individuals in the relevant program population or through a related community-based organization.
• Equivalent combinations of education, training, and directly relevant experience may be considered.
• Experience working with individuals who have chronic illnesses, disabilities, co-morbidities, behavioral-health needs, social determinants of health barriers, or complex community-service needs.
• Ability to conduct member assessments using structured tools, collect relevant information, identify support needs, and coordinate follow-up activities.
• Strong communication, relationship-building, organization, documentation, and time-management skills.
• Ability to work independently in a field-based environment while maintaining close collaboration with a remote or interdisciplinary team.
• Reliable transportation and willingness to travel frequently within the assigned service area.
• Proficiency with Microsoft Office applications and electronic documentation systems.

Preferred Qualifications

• Bachelor’s degree in healthcare, public health, social work, human services, community health, or another related health-focused discipline.
• Experience in care coordination, case management, community outreach, health-plan programs, Medicaid, Medicare, managed care, home- and community-based services, or social-service navigation.
• Experience working with diverse, vulnerable, underserved, elderly, disabled, or medically complex populations.
• Familiarity with community resources, local provider networks, social-service agencies, and social determinants of health.
• Bilingual language skills relevant to the assigned member population.
• Community Health Worker certification.

Benefits

• Medical, dental, and vision insurance are available to qualified candidates who meet eligibility requirements.

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