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Elevance Health

Sells health insurance and pharmacy benefits

CFSP Managed Care Coordinator

Case Management & AdvocacyUpdated on Nov 11
Full-timeRaleigh, NC, USANo salary listed

About the Job

Requirements

  • A bachelor's degree or equivalent combination of education and experience is required.
  • At least one year of experience working directly with people related to the specific program population or with related community-based organizations is required.
  • Candidates must reside in North Carolina.
  • Candidates must travel to the worksite and other locations as necessary.

Responsibilities

  • Provide integrated whole-person care management under the CFSP Care Management model, coordinating physical health, behavioral health, intellectual and developmental disabilities, long-term services and supports, pharmacy, and unmet health-related needs.
  • Provide trauma-informed care by recognizing the role of adverse childhood experiences in the CFSP population and coordinating cross-agency care for children's physical, behavioral, social, educational, and legal needs.
  • Collaborate 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 child welfare stakeholders, to coordinate care, including 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 and coordinate their cases with clinical healthcare management and an interdisciplinary team for care coordination support.
  • Oversee non-clinical needs of members with chronic illnesses, comorbidities, or disabilities to support 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.

Desired Qualifications

  • A bachelor's degree in a field related to health, psychology, sociology, social work, nursing, or another relevant human-services area is preferred.
  • Two years of experience working directly with individuals served by the child welfare system is preferred.

About the Company

Elevance Health

Sells health insurance and pharmacy benefits

Elevance Health is one of the largest U.S. health insurers, covering people through employers, individual plans, Medicare and Medicaid. It is the Blue Cross Blue Shield licensee in 14 states, where it sells plans under the Anthem name, and it runs government plans under the Wellpoint name in other markets. Its Carelon division runs the CarelonRx pharmacy benefit manager and sells behavioral health, care management and other services to its own plans and outside clients. Elevance earns most of its revenue from premiums paid by employers, members and government programs, plus fees for Carelon services. The company is headquartered in Indianapolis, Indiana.

Company size
10,001+
Company stage
IPO
Headquarters
Indianapolis, IN
Founded
1944

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