RN Clinician

1 week ago

Roanoke, Virginia, United States Elevance Health Full time
Job Title: LTSS Service Coordinator

This is a field position that requires residing in Salem, Roanoke, Montgomery, and Craig counties.

Job Summary:

The LTSS Service Coordinator RN Clinician is responsible for managing member cases within the scope of licensure. They provide supervision and direction to non-RN clinicians, develop, monitor, evaluate, and revise care plans to meet member needs, and optimize healthcare across the care continuum.

Key Responsibilities:
  • Perform face-to-face clinical assessments to identify, evaluate, coordinate, and manage member needs, including physical health, behavioral health, social services, and long-term services and supports.
  • Identify members at high risk for complications and coordinate care with the member and healthcare team.
  • Manage members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost-effective and efficient utilization of health benefits.
  • Develop individual care plans in collaboration with members, caregivers, family, natural supports, and physicians.
  • Establish short- and long-term goals and identify members who may benefit from alternative levels of care or other waiver programs.
  • Ensure member access to services and may assist with implementing care plans by facilitating authorizations/referrals for services within benefits structures or through extra-contractual arrangements.
  • Interface with Medical Directors, Physician Advisors, and Inter-Disciplinary Teams on care management treatment plans.
  • Direct and/or supervise the work of LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals in coordinating services for members.
Requirements:
  • Requires an RN with a minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role.
  • Current, unrestricted RN license in applicable state(s) required. May require state-specified certification based on state law and/or contract.
Preferred Skills, Knowledge, and Experience:
  • MA/MS in Health/Nursing preferred.
  • Travels to worksite and other locations as necessary.

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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