LTSS Service Coordinator

LTSS Service Coordinator (Case Manager) Candidates should live in one of the following counties: Adam, Butler, Carroll, Columbiana, Defiance, Hamilton, Harrison, Jackson, Lawrence, Van Wert, Williams. Location : This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands?on engagement. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The MyCare Ohio health plan is to deliver high?quality, trauma informed, culturally competent, person?centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. The LTSS Service Coordinator is responsible for managing service coordination for a designated caseload in specialized programs. Collaborate with individuals to lead the Person Centered Planning process, documenting their preferences, needs, and goals. Conduct assessments, create comprehensive Person Centered Support Plans (PCSP), and develop backup plans. Work with Medical Directors and partake in interdisciplinary care rounds to establish a fully integrated care plan. Engage the individual's support network and oversee management of their physical health, behavioral health, and long?term services and supports, adhering to state and federal regulations. How you will make an impact Responsible for performing face to face program assessments (using various tools with pre?defined questions) for identification, applying motivational interviewing techniques for evaluations, coordination, and management of an individuals waiver (such as LTSS/IDD), and BH or PH needs. Uses tools and pre?defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high?risk complications, addresses gaps in care) and coordinates those members cases (serving as the single point of contact) with the clinical healthcare management and interdisciplinary team in order to provide care coordination support. Manages non?clinical needs of members with chronic illnesses, co?morbidities, and/or disabilities, to ensure cost effective and efficient utilization of long?term services and supports. At the direction of the member, documents their short and long?term service and support goals in collaboration with the members chosen care team that may include, caregivers, family, natural supports, service providers, and physicians. Identifies members that would benefit from an alternative level of service or other waiver programs. May also serve as mentor, subject matter expert or preceptor for new staff, assisting in the formal training of associates, and may be involved in process improvement initiatives. Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individuals care plan. Responsible for reporting critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement). Assists and participates in appeal or fair hearings, member grievances, appeals, and state audits. Minimum Requirements Requires BA/BS degree and a minimum of 2 years of experience working with a social work agency; or any combination of education and experience which would provide an equivalent background. Preferred Skills, Capabilities and Experiences Strong preference for case management experience with older adults or individuals with disabilities. BA/BS in Health/Nursing preferred. 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 elevancehealthjobssupport@elevancehealth.com 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. #J-18808-Ljbffr