RN Lead Clinician

4 days ago


Grand Prairie, Texas, United States Elevance Health Full time
Job Title: LTSS Service Coordinator - RN Lead Clinician

Elevance Health is seeking a highly skilled RN Lead Clinician to join our team as an LTSS Service Coordinator. This role is responsible for leading a team and assisting management with day-to-day activities, such as workforce management and monitoring and prioritizing workflow.

Key Responsibilities:
  • Performs quality audits to ensure care plans are designed to optimize members' physical, behavioral, and social needs.
  • Assists in the development and maintenance of policies and procedures, training materials, and job resources.
  • Leads projects and participates in workgroups with cross-functional teams and serves as a representative on business unit/enterprise initiatives.
  • Performs process evaluations and tests and monitors systems/process enhancements.
  • Serves as the first line contact for conflict resolution.
  • Participates in the Internal Appeal Process.
  • Responsible for overall management of members' cases within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract.
  • Develops, monitors, evaluates, and revises members' care plans to meet their needs, with the goal of optimizing member healthcare across the care continuum.
  • Responsible for performing telephonic or face-to-face clinical assessments for the identification, evaluation, coordination, and management of members' needs, including physical health, behavioral health, social services, and long-term services and supports.
  • Identifies members for high-risk complications and coordinates care in conjunction with the member and the healthcare team.
  • Manages members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost-effective and efficient utilization of health benefits.
  • Obtains a thorough and accurate member history to develop an individual care plan.
  • Establishes short- and long-term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs.
  • The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services.
  • May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible.
  • Interfaces with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on the development of care management treatment plans.
  • Assists in problem-solving with providers, claims, or service issues. Serves as the first line contact for conflict resolution.
  • Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example, assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these individuals, conducting additional assessments, as necessary, to develop, monitor, evaluate, and revise the member's care plan to meet the member's needs, and reviewing and providing input on the non-RN clinicians' performance on a regular basis.
  • Serves as a mentor or preceptor for new staff, assists in formal training, and may be involved in process improvement initiatives.
  • May also serve as lead to non-licensed LTSS Service Coordinators as applicable by state law and contract.
Requirements:
  • Requires an RN and a minimum of 5 years of clinical care experience and a minimum of 5 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.
  • Current, unrestricted RN license in applicable state(s) required. BA/BS in a health-related field preferred.
  • May require state-specified certification based on state law and/or contract.
Preferred Skills, Knowledge, and Experience:
  • Certification as a Managed Care Nurse (CMCN) preferred.
  • MA/MS in Health/Nursing preferred.
  • Travels to worksite and other locations as necessary.
Job Level: Non-Management Non-Exempt

  • Grand Prairie, Texas, United States Elevance Health Full time

    Job SummaryElevance Health is seeking a highly skilled RN Lead Clinician to lead our LTSS Service Coordinator team. As a key member of our team, you will be responsible for leading a team of clinicians and assisting management with day-to-day activities, including workforce management and workflow prioritization.Key ResponsibilitiesLead a team of clinicians...


  • Grand Prairie, Texas, United States Elevance Health Full time

    Job DescriptionElevance Health is seeking a highly skilled LTSS Service Coordinator-RN Lead Clinician to join our team. As a key member of our team, you will be responsible for leading a team and assisting management with day-to-day activities, such as workforce management and monitoring and prioritizing workflow.Key Responsibilities:Performs quality audits...

  • RN Clinician

    1 week ago


    Grand Prairie, Texas, United States Elevance Health Full time

    Job Summary:Elevance Health is seeking a skilled RN Clinician - Service Coordinator to join our team. As a key member of our healthcare team, you will be responsible for managing member cases, providing supervision and direction to non-RN clinicians, and developing, monitoring, evaluating, and revising care plans to meet member needs.Key...

  • RN Clinician

    3 days ago


    Grand Prairie, Texas, United States Elevance Health Full time

    Job Title: LTSS Service Coordinator RN ClinicianJob Summary:We are seeking a highly skilled RN Clinician to serve as a LTSS Service Coordinator. The successful candidate will be responsible for managing member cases within the scope of licensure, providing supervision and direction to non-RN clinicians, and developing, monitoring, evaluating, and revising...

  • RN Care Coordinator

    1 week ago


    Grand Prairie, Texas, United States Elevance Health, Inc. Full time

    Key Responsibilities: Identify members at risk for complications and coordinate care with the member and healthcare team. Manage members with chronic illnesses, co-morbidities, and disabilities to ensure cost-effective and efficient utilization of healthcare resources. Collaborate with the healthcare team to develop and implement care plans that meet the...


  • Grand Prairie, Texas, United States Elevance Health Full time

    Job Summary:The LTSS Service Coordinator Clinician will contribute to the LTSS care coordination process by performing activities within the scope of licensure. This includes assisting the responsible RN with telephonic assessments for the identification, evaluation, coordination, and management of member needs. The ideal candidate will have experience...

  • Physical Therapist

    2 weeks ago


    Grand Prairie, Texas, United States H2 Health Full time

    Job OpportunityAt H2 Health, we're committed to delivering exceptional patient care and providing a supportive work environment for our clinicians. As a Physical Therapist, you'll have the opportunity to work with a dynamic team in a luxury Senior Living community in Grand Prairie, TX.Why Choose H2 Health?Clinicians leading clinicians: Our team is driven by...


  • Grand Prairie, Texas, United States H2 Health Full time

    Job OpportunityAt H2 Health, we're committed to delivering exceptional patient care in senior living communities. As a Physical Therapist Assistant, you'll have the opportunity to provide 1:1 care and make a meaningful impact in the lives of our residents.Key Responsibilities:Provide therapy services to residents in a luxury senior living settingCollaborate...


  • Grand Prairie, Texas, United States H2 Health Full time

    Unlock Your Potential as a Physical Therapist AssistantH2 Health is seeking a dedicated and compassionate Physical Therapist Assistant to join our team. As a member of our interdisciplinary team, you will have the opportunity to provide high-quality patient care and make a meaningful impact in the lives of those you serve.Why Choose H2 Health?Clinicians...


  • Grand Prairie, Texas, United States H2 Health Full time

    Job TypeFull-time, Part-timeDescriptionH2 Health Prime Living is seeking a skilled Physical Therapist Assistant to provide 1:1 patient care in our luxury Senior Living communities in Grand Prairie and surrounding areas.We offer a dynamic and supportive work environment where you can thrive and grow professionally. As a Physical Therapist Assistant, you will...


  • Grand Prairie, Texas, United States CenterWell Home Health Full time

    About the RoleCenterWell is seeking a Primary Care Clinic Manager to lead the development and implementation of staffing plans, policies, and procedures for the facility. This role will work closely with clinicians to ensure optimal patient outcomes and company initiatives, including quality, HEDIS/STARS, AHCA, financial management, and employee and patient...


  • Grand Prairie, Texas, United States ATI Physical Therapy Full time

    Job SummaryWe are seeking a highly skilled and motivated Physical Therapist to join our team at ATI Physical Therapy. As a Travel Physical Therapist, you will have the opportunity to work in various outpatient settings, providing high-quality care to patients and contributing to the growth and development of our team.ResponsibilitiesEvaluate and treat...

  • Travel Med Surg RN

    4 weeks ago


    Grand Prairie, Texas, United States Leoforce Full time

    Travel Med Surg RN Job OpportunityWe are seeking a skilled Medical Surgical Nurse to join our team for a travel assignment in Arlington, TX.Job Highlights:Competitive hourly rate of $15.75-$15.75Eligible for per diemsSeasonal/annual adjustmentAbout the Job:This travel healthcare position offers a unique opportunity to work with a reputable healthcare...

  • Travel Med Surg RN

    4 weeks ago


    Grand Prairie, Texas, United States Leoforce Full time

    Travel Med Surg RN Job OpportunityWe are seeking a skilled Medical Surgical Nurse to join our team for a travel assignment in Arlington, TX.Job Highlights:Competitive hourly rate of $15.75-$15.75Eligible for per diemsSeasonal/annual adjustmentAbout the Job:This travel healthcare position offers a unique opportunity to work with a reputable healthcare...


  • Grand Prairie, Texas, United States Medical City Dallas Full time

    Job SummaryThe Clinical Nurse Coordinator (CNC) plays a vital role in delivering high-quality, patient-centered care and coordinating all functions in the PCU unit. In partnership with the management team, the CNC monitors and evaluates nursing care in accordance with established policies.Key ResponsibilitiesPartner with a multidisciplinary team to...


  • Grand Prairie, Texas, United States Medical City Dallas Full time

    Job SummaryThe Clinical Nurse Coordinator (CNC) plays a pivotal role in delivering exceptional patient care and coordinating unit functions at Medical City Dallas. In partnership with the management team, the CNC monitors and evaluates nursing care, ensuring alignment with established policies. This position serves as a resource for staff, supporting an...


  • Grand Prairie, Texas, United States Medical City Dallas Full time

    Job SummaryThe Clinical Nurse Coordinator (CNC) plays a pivotal role in delivering exceptional patient care and coordinating unit functions at Medical City Dallas. In partnership with the management team, the CNC monitors and evaluates nursing care, ensuring alignment with established policies. This position serves as a resource for staff, supporting an...


  • Grand Prairie, Texas, United States CenterWell Home Health Full time

    About the RoleWe are seeking a highly skilled and experienced Clinic Manager to join our team at CenterWell Senior Primary Care. As a Clinic Manager, you will be responsible for developing and implementing strategic plans to ensure the optimal delivery of patient care and services.Key ResponsibilitiesDevelop and implement operational plans to meet business...


  • Grand Prairie, Texas, United States Medical City Dallas Full time

    Job SummaryThe Clinical Nurse Coordinator (CNC) plays a vital role in delivering high-quality, patient-centered care and coordinating all functions in the PCU unit. In partnership with the management team, the CNC monitors and evaluates nursing care in accordance with established policies.ResponsibilitiesPartner with a multidisciplinary team to coordinate,...


  • Grand Prairie, Texas, United States CenterWell Home Health Full time

    Job SummaryCenterWell Senior Primary Care is seeking a highly skilled and experienced Healthcare Operations Manager to join our team. As a key member of our leadership team, you will be responsible for developing and implementing strategic plans to drive operational excellence and improve patient outcomes.Key ResponsibilitiesDevelop and implement operational...