LTSS Service Coordinator-RN Lead Clinician

4 weeks ago


Grand Prairie, Texas, United States Elevance Health Full time
Job Summary

Elevance 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 Responsibilities
  • Lead a team of clinicians and assist management with day-to-day activities
  • Perform quality audits to ensure care plans optimize member needs
  • Develop and maintain policies and procedures, training materials, and job resources
  • Lead projects and participate in workgroups with cross-functional teams
  • Perform process evaluations and test system enhancements
  • Serve as first-line contact for conflict resolution
  • Participate in the Internal Appeal Process
  • Responsible for overall management of member cases within the scope of licensure
Requirements
  • Current, unrestricted RN license in applicable state(s) required
  • Minimum 5 years clinical care experience and 5 years experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities
  • BA/BS in health-related field preferred
Preferred Skills
  • Certification as a Managed Care Nurse (CMCN) preferred
  • MA/MS in Health/Nursing preferred
About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.


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