Join to apply for the Managed Care Coordinator role at Elevance Health
Location & Field
The candidate should be located in Spotsylvania or Fredericksburg, VA. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Responsibilities
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 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.
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
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.
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, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in 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.