Managed Care Coordinator at Elevance Health

North Carolina, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Medicaid Managed CareIndustries

Requirements

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 related field

Responsibilities

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-agency 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
Manage the overall member’s individual service plan within the scope of the position in the NC CFSP Program, as required by applicable state law and contract

Skills

Key technologies and capabilities for this role

Managed CareCare CoordinationMedicaidService PlanningCase ManagementChild WelfareBehavioral HealthPatient Interaction

Questions & Answers

Common questions about this position

Is this a remote position or does it require in-person work?

This is a field-based role requiring you to interact with patients, members, or providers in person four to five days per week, with occasional office attendance for meetings or training. Candidates must be within a reasonable commuting distance from the posting locations in specified North Carolina counties.

What are the key responsibilities of the Managed Care Coordinator?

The role involves providing integrated whole-person Care Management, offering Trauma-Informed Care, collaborating with County Child Welfare Workers, working with multidisciplinary teams, and conducting assessments to manage member needs.

What locations is this position available in?

The role is field-based in specific North Carolina counties including Alexander, Alleghany, Watauga, Cherokee, Clay, Graham, and Transylvania, with Alexander County (Taylorsville) highlighted.

What salary or compensation does this position offer?

This information is not specified in the job description.

What experience or skills make a strong candidate for this role?

Strong candidates should have experience in care management, trauma-informed care, collaborating with child welfare and multidisciplinary teams, and conducting assessments, particularly in supporting children and families in the child welfare system.

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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