LTSS Service Coordinator RN Clinician
2 weeks ago
Job Summary:
The LTSS Service Coordinator RN Clinician is responsible for managing member cases within the scope of licensure. This role involves providing supervision and direction to non-RN clinicians, developing and revising care plans to meet member needs, and performing face-to-face clinical assessments to identify, evaluate, and coordinate member needs.
Key Responsibilities:
- Identify members at high 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 health benefits.
- Obtain thorough and accurate member histories to develop individual care plans.
- Establish short- and long-term goals in collaboration with members, caregivers, family, natural supports, and physicians.
- Develop and implement care plans for services, ensuring member access to those services.
- Assist with implementing member care plans by facilitating authorizations and 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 non-RN clinicians 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.
- Ability to travel to worksite and other locations as necessary.
Work Environment:
This is a field position, and the candidate should reside in Arlington, Alexandria, Loudon County, or Prince William Counties.
Company Overview:
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.
Equal Employment Opportunity:
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.
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