Clinical Care Advisor - Complex Medical Healthy Blue Care Together CFSP

Clinical Care Advisor – Complex Medical Healthy Blue Care Together CFSP

Join to apply for the Clinical Care Advisor – Complex Medical Healthy Blue Care Together CFSP role at Elevance Health
.

$3,500 SIGN ON BONUS

Disabilities (I/DD) services, long term services and supports, Unmet health-related resource needs, and Integrated care management. We envision a North Carolina where all children and families thrive in safe, stable, and nurturing homes.

North Carolina residency is required!

• Region 6 counties:
  Bladen, Brunswick, Carteret, Columbus, Craven, Cumberland, Duplin, Jones, Lenoir, New Hanover, Onslow, Pamlico, Pender, Perquimans, and Sampson
• Region 7 counties:
  Beaufort, Bertie, Camden, Chowan, Currituck, Dare, Gates, Hertford, Hyde, Martin, Pasquotank, Perquimans, Tyrrell, and Washington

Travel within your assigned DSS Region is required. When you are not in the field, you will work virtually from your home. These roles are statewide field‑based and require interaction with patients, members, or providers in person four to five days per week. This is a collaborative role with the field care managers for the CFSP program, with the advisors supporting the care managers with consulting on complex medical or IDD cases.

This field‑based role enables associates to primarily operate in the field, traveling to client sites or designated locations as the role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands‑on engagement.

Please note that per our policy on hybrid/virtual work, 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.

The assistant is responsible for the Children and Families Specialty Plan integrated physical health and behavioral health care management teams and for the development, implementation, and coordination of a comprehensive clinical program designed specifically to manage the health and wellness outcomes of youth in foster care and adoption assistance, including highly complex members with varying degrees of medical and behavioral health complexity and acuity.

Manages overall healthcare costs, case management and whole‑person health.

• Engage collaboratively with key stakeholders—including families, foster parents, and service teams—to craft and sustain individualized treatment plans.
• Conduct assessments to identify individual needs.
• Develop comprehensive care plans to address objectives and goals as identified during assessment.
• Support member access to appropriate quality and cost‑effective care and modify plan(s) as needed.
• Coordinate with internal and external resources to meet identified needs of the member in terms of integrated (physical and behavioral) whole‑person care.
• Coordinate social determinants of health to meet the needs of the member and incorporate that into care planning.
• Work closely with various state agencies.
• Maintain knowledge of the system‑of‑care philosophy; a spectrum of effective, community‑based services and supports for those with or at risk for mental health or other challenges and their families, that is organized into a coordinated network.
• Build meaningful partnerships with designated populations and their families, and address cultural and linguistic needs, in order to help them function better at home, in the community, and throughout life.
• Evaluate health needs and identify applicable services and resources in conjunction with members and their families.
• Provide important information including patient education, medication reconciliation, and identification of community resources and assist with arrangement of follow‑up care.
• Facilitate health rounds with other clinical‑centered professionals to ensure whole‑person health.
• May lead and work on specialty projects and initiatives.
• Assist with process‑improvement activities.
• Train and mentor staff.
• Perform case/chart audits and ensure departmental compliance.
• Serve as a member of the leadership team.