CFSP Managed Care Coordinator
Sign-on Bonus: $2500
We are currently seeking people in the following counties: Bladen, Brunswick, Carteret, Columbus, Craven, Cumberland, Duplin, Jones, Lenoir, New Hanover, Onslow, Pamlico, Pender, Perquimans, and Sampson.
Location: Field-based role. The primary work is in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training. Note: Candidates not within reasonable commuting distance from the posting location(s) will not be considered, unless an accommodation is granted as required by law.
These roles are statewide field-based and require interaction with patients, members, or providers in person four to five days per week.
We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system so that they receive seamless, integrated, and coordinated health care. Within the Children and Families Specialty Plan (CFSP), members will have access to the same basic benefits and services—physical health, behavioral health, pharmacy, intellectual/developmental disabilities (I/DD), long‑term services and supports, unmet health‑related resource needs, and integrated care management—regardless of where a member lives.
How you will make an impact
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 the role of ACEs in the CFSP population and coordinating cross‑agency care to support children’s diverse needs.
Collaborate closely with each Member’s County Child Welfare Worker to align health care needs with permanency planning goals.
Work with a multidisciplinary care team—including primary health care and behavioral health professionals, specialty providers, and child welfare stakeholders—to coordinate care (e.g., coordination involving juvenile justice awareness).
Conduct telephonic or face‑to‑face assessments using predefined questions to identify, evaluate, coordinate, and manage member program needs.
Identify members with potential clinical health care needs using predefined tools, coordinating their cases with clinical healthcare management and an interdisciplinary team for care coordination support.
Oversee non‑clinical needs of members with chronic illnesses, comorbidities, or disabilities for cost‑effective and efficient service utilization.
Set short‑ and long‑term goals in collaboration with members, caregivers, families, natural supports, and physicians.
Identify members who would benefit from expanded services.
Minimum 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.
Preferred Skills, Capabilities, And Experiences
Must reside in North Carolina.
BA/BS degree preferred in a field related to health, psychology, sociology, social work, nursing or another relevant human services area.
Two (2) years of experience working directly with individuals served by the child welfare system is preferred.
Travels to worksite and other locations as necessary.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates 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.
Appreciation for COVID‑19 and Influenza vaccination is required for new candidates in certain patient/member‑facing roles. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, gender, marital status, national origin, religion, sexual orientation, veteran status, or any other protected status or condition. Any applicant requiring accommodation for the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.