Member Care Coordinator - Health Plan Support (Hybrid)

Elevance Health; Greenville (NC); Hybrid; USD 42,000 - 64,000; Full time

Benefits offered by this job

Major medical

HSA

Dental

Vision

Employer-provided group life

Voluntary life insurance

Short-term disability

Long-term disability

401k

Job summary

Elevance Health is seeking a Care Coordinator to support member services and care management under state requirements. You will perform telephonic or face-to-face assessments, identify needs, coordinate with the care team, and help manage non-clinical aspects of member care.

Requires BA/BS in a health-related field and at least 1 year of relevant experience; Community Health Worker certification may be required within one year.

Qualifications

• BA/BS degree in health care related field required or equivalent.
• Minimum 1 year of experience working with the target program population or related community-based organizations.
• Community Health Worker certification may be required within one year of employment where applicable.

Responsibilities

• Manage overall member care coordination within state requirements.
• Perform telephonic or face-to-face history and needs assessments.
• Identify members with potential clinical needs and coordinate with clinical team.
• Manage non-clinical needs of members to ensure cost-effective utilization of services.
• Collaborate on short and long-term goals with member and care network.

Education

BA/BS in health care field

1 year experience with program population

Community Health Worker certification (within 1 year)

Job description

Please note this is the target date and is subject to change. BCForward will send official notice ahead of a confirmed start date.

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 members and the communities we serve.

Use only in markets where the state law and contract do not require Mgd Care Coordinators to be licensed.

Primary duties may include, but are not limited to:

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 (including, but not limited to, potential for high risk complications) 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 ensure cost effective and efficient utilization of services.

Establishes short and long-term goals in collaboration with the member, caregivers, family, natural support, and physicians.

Identifies members that would benefit from expanded services.

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.

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.

For MMP, requires Community Health Worker certification to be obtained within one year of employment.

Job Type: Possible contract to hire

Work schedule: Mon- Fri, 8-5pm EST; 40 hours a week with occasional evening hours or overtime required

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, contractors are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

About BCForward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCForward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Benefits Information

BCForward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. This does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).