Managed Care Coordinator

About This Role

This Managed Care Coordinator role focuses on the overall management of a member's individual service plan, performing telephonic or face-to-face needs assessments, and coordinating cases with a clinical healthcare management team. The position suits a professional dedicated to improving lives and communities by making healthcare simpler, working within the scope of applicable state law and contract.

Responsibilities

• Manage member's individual service plan within the scope of the position, as required by applicable state law and contract
• Perform telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination, and management of member's program needs
• Identify members with potential clinical health care needs (including, but not limited to, potential for high risk complications) using tools and a pre-defined identification process
• Coordinate identified member cases with the clinical healthcare management and interdisciplinary team to provide care coordination support
• Manage non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost-effective and efficient utilization of services
• Establish short and long-term goals in collaboration with the member, caregivers, family, natural supports, and physicians
• Identify members that would benefit from expanded services

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
• Ability to travel to worksite and other locations as necessary
• Must reside in Henderson County
• Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location

Nice to have:

• BA/BS degree field of study in a healthcare-related field
• For MMP, Community Health Worker certification to be obtained within one year of employment

Important Details

• Contract: 5 months 27 days, possible contract to hire
• Anticipated Start Date: September 21, 2026
• Schedule: Monday - Friday, 8 AM - 5 PM EST; 40 hours a week with occasional evening hours or overtime required
• Work format: Hybrid Workforce Strategy, contractors are required to work at an Elevance Health location at least once per week, and potentially several times per week

About the Company

Elevance Health is a Fortune 25 health company dedicated to improving lives and communities and making healthcare simpler. BCforward, founded in 1998, is a Black-owned firm providing professional service and workforce management expertise, headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India. BCforward's 6,000 consultants support more than 225 clients globally.