Member Care Coordination Specialist

Elevance Health; Eden (NC); Hybrid; USD 42,000 - 66,000; Full time

Benefits offered by this job

Medical benefits

Hybrid work model

Job summary

Elevance Health is seeking a Health Care Coordinator to manage members' individual service plans within state-law and contract guidelines. The role involves telephonic or in-person assessments to identify and address program needs, and coordinating care with the clinical team to support member goals.

Travel to worksites as needed; requires BA/BS in health care field and at least 1 year of relevant experience.

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.
• BA/BS degree field of study in health care related field preferred. Specific education and years and type of experience may be required based upon state law and contract requirements.
• Travels to worksite and other locations as necessary.

Responsibilities

• Responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract.
• Responsible for performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's program needs.
• Using tools and pre-defined identification process, identifies members with potential clinical health care needs and coordinates those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
• The process does not involve clinical judgment.
• Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of services.
• Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, and physicians.
• Identifies members that would benefit from expanded services.

Skills

Care coordination

Telephonic assessments

Clinical collaboration

Member support

Education

BA/BS in health care field

Job description

Elevance Health is seeking a Health Care Coordinator to manage members' individual service plans within state-law and contract guidelines. The role involves telephonic or in-person assessments to identify and address program needs, and coordinating care with the clinical team to support member goals.

Travel to worksites as needed; requires BA/BS in health care field and at least 1 year of relevant experience.