Long-Term Services and Supports Specialist
2 weeks ago
Position Overview:
Title:
Bilingual LTSS Service Coordinator (English/Spanish)
Job Summary:
The LTSS Service Coordinator plays a crucial role in providing service coordination for a designated group of individuals enrolled in specialized programs. This position is primarily field-based, requiring home-based work combined with in-person meetings with patients and healthcare providers. Travel to various locations is necessary.
The coordinator is tasked with facilitating the Person-Centered Planning process, which includes documenting the individual's preferences, needs, and self-identified goals. This involves conducting assessments, developing a comprehensive Person-Centered Support Plan (PCSP), and engaging with Medical Directors while participating in interdisciplinary care discussions to ensure a fully integrated care plan. The coordinator will also manage the individual's physical health (PH), behavioral health (BH), and LTSS needs in accordance with state and federal regulations.
Key Responsibilities:
1. Conduct face-to-face program assessments utilizing established tools and motivational interviewing techniques to evaluate and manage the individual's waiver needs, including LTSS/IDD and BH or PH requirements.
2. Identify members with potential clinical healthcare needs and coordinate their cases with the clinical healthcare management team to provide comprehensive care coordination support.
3. Manage the non-clinical needs of members with chronic conditions and disabilities, ensuring efficient utilization of long-term services and supports.
4. Collaborate with the member's chosen care team, including caregivers and service providers, to document short and long-term service goals.
5. Identify members who may benefit from alternative service levels or waiver programs.
6. Mentor and train new staff, contributing to process improvement initiatives.
7. Submit utilization and authorization requests to management, ensuring alignment with the individual's care plan.
8. Report critical incidents to relevant internal and external parties, including state and county agencies, and assist in appeals and audits.
Qualifications:
Requires a BA/BS degree and a minimum of 2 years of experience in a social work agency or a combination of education and experience that provides an equivalent background. Specific requirements may vary based on state law and contract stipulations.
Preferred Skills:
1. BA/BS degree in a healthcare-related field is preferred.
2. Bilingual proficiency in English and Spanish is strongly preferred.
Work Environment:
This position is classified as Non-Management Non-Exempt and typically operates during the first shift. Elevance Health promotes a hybrid workforce strategy, requiring associates to work onsite at least once a week unless specified otherwise.
Company Overview:
Elevance Health is committed to enhancing lives and communities while simplifying healthcare. As a Fortune 25 company, we seek passionate leaders at all levels who are dedicated to making a positive impact on our members and the communities we serve.
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