Clinical Care Advisor - Prevention and Preservation (DSS Regions 1 & 2) at Elevance Health

Asheville, North Carolina, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

NoVisa

Healthcare, Medicaid Managed CareIndustries

Requirements

North Carolina residency required
Located within DSS Regions 1 or 2 counties (Region 1: Buncombe, Cherokee, Clay, Graham, Haywood, Henderson, Madison, Polk, Swain, Transylvania, Yancey, Macon, Jackson, Mitchell; Region 2: Alexander, Alleghany, Ashe, Avery, Burke, Caldwell, Catawba, Cleveland, Gaston, Iredell, Lincoln, McDowell, Rutherford, Watauga, Wilkes)
Within reasonable commuting distance from posting location(s), unless accommodation granted
Ability to travel within assigned DSS Region required
Field-based role: interact with patients, members, or providers in person 4-5 days per week; work virtually from home otherwise
Scope of licensure for performing case management telephonically and/or by home visits

Responsibilities

Coordinate operations and workflows related to case management activities in support of specialty programs, such as Foster Care
Serve as coach
Perform case management telephonically and/or by home visits within the scope of licensure
Manage overall healthcare costs for the designated population via integrated (physical health/behavioral health) case management and whole person health
Manage the most complex cases and provide support to Special Programs case managers
Provide compassionate support to children and families involved in the CFSP Foster Care system, emphasizing strengthening family bonds and delivering services to those at risk of entering foster care
Conduct assessments to identify individual needs
Develop comprehensive care plans to address objectives and goals identified during assessment
Support member access to appropriate quality and cost-effective care and modify plans 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 member needs and incorporate into care planning
Work closely with various state agencies
Maintain knowledge of the system of care philosophy (spectrum of effective, community-based services and supports organized into a coordinated network)
Build meaningful partnerships with designated populations and their families, addressing cultural and linguistic needs

Skills

Medicaid

Child Welfare

Case Management

Healthcare Coordination

Behavioral Health

I/DD Services

Long Term Services and Supports

Patient Interaction

Field-Based Care

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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