Managed Care Coordinator - Craven

Managed Care Coordinator – Craven County

Sign‑on Bonus: $2,500

We are currently seeking people in the following counties:
Craven, Lenoir, Pitt, Jones, Pamlico, Carteret, and Beaufort.

Location: This field‑based role is in Craven County and requires traveling to client sites or designated locations four to five days per week, with occasional office attendance for meetings or training.

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.

The CFSP Managed Care Coordinator is responsible for the overall management of the members’ individual service plan within the scope of the position inوله NC CFSP Program, as required by applicable state law and contract.

• Provide integrated whole‑person Care Management under the CFSP Care Management model, including coordination 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
  
  Discover care to support children’s diverse needs, including physical, behavioral, social, educational, and legal aspects.
• 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 stakeholders in the child welfare system, 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, co‑morbidities, 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.

• 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.

• 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 cuarto preferred.
• Colocation is a possibility that could require reporting to office location 1–3 days per week as needed.
• Travel to worksite and other locations as necessary.

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 elevancehealthj 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.