Member Care Coordination Specialist

Elevance Health; Gastonia (NC); Hybrid; USD 52,000 - 78,000; Full time

Benefits offered by this job

Major medical

HSA

Dental

Vision

Life insurance

Disability insurance

401k

Job summary

Elevance Health is seeking a care coordination professional to manage members’ individual service plans, conduct needs assessments, and coordinate with clinical teams. The role involves identifying high-need members, addressing non-clinical needs, and collaborating with caregivers and physicians to set achievable goals.

Requires a BA/BS in a health-related field and at least 1 year of relevant experience, with travel as needed.

Qualifications

• BA/BS degree field of study in health care related field preferred; state requirements may apply.
• At least 1 year of experience working with the program population or related community-based organizations.
• Willingness to travel to worksite and other locations as necessary.
• For MMP, Community Health Worker certification within one year of employment.

Responsibilities

• Oversee the overall management of the member's individual service plan within state law and contract.
• Conduct telephonic or in-person history and needs assessments to identify, evaluate, coordinate, and manage program needs.
• Identify members with potential clinical health care needs and coordinate cases with the clinical care team.
• Manage non-clinical needs of members with chronic illnesses to ensure cost-effective service use.
• Set short- and long-term goals with members, caregivers, and physicians.
• Identify members who could benefit from expanded services.

Skills

Communication skills

Care coordination

History-taking

Education

BA/BS degree in health care field

1 year relevant experience

Job description

Elevance Health is seeking a care coordination professional to manage members’ individual service plans, conduct needs assessments, and coordinate with clinical teams. The role involves identifying high-need members, addressing non-clinical needs, and collaborating with caregivers and physicians to set achievable goals.

Requires a BA/BS in a health-related field and at least 1 year of relevant experience, with travel as needed.