LTSS Care Coordination Specialist

2 weeks ago

Indianapolis, Indiana, United States Elevance Health Full time

Position Overview

The LTSS Service Coordinator – RN Clinician plays a crucial role in managing the care of members within their professional licensure. This position involves guiding non-RN clinicians in accordance with state regulations and contractual obligations, while also developing, monitoring, and adjusting individualized care plans to meet the unique needs of each member.

Key Responsibilities:

  • Conduct comprehensive clinical assessments through telephonic or in-person interactions to evaluate and coordinate the diverse needs of members, including physical health, mental health, social services, and long-term care supports.
  • Identify members at risk for complications and collaborate with the healthcare team to ensure appropriate care coordination.
  • Oversee the management of members with chronic conditions, co-morbidities, and disabilities to promote effective utilization of healthcare benefits.
  • Compile detailed member histories to facilitate tailored care planning.
  • Set collaborative goals with members, their families, caregivers, and healthcare providers; determine eligibility for various care levels or waiver programs.
  • Design care plans that ensure members have access to necessary services.
  • Assist in executing care plans by organizing authorizations and referrals for service utilization within the benefits framework.
  • Work closely with Medical Directors and Inter-Disciplinary Teams to develop and implement care management strategies.
  • Address and resolve any issues related to providers, claims, or services.
  • Supervise LPNs, LVNs, LSWs, LCSWs, LMSWs, and other licensed professionals in the delivery of member services.

Qualifications:

  • Must possess an RN license with a minimum of 3 years of experience working with individuals facing chronic illnesses, co-morbidities, or disabilities in a Service Coordinator or Case Management capacity; or possess equivalent education and experience.
  • Current, unrestricted RN license in the applicable state(s) is required.

Preferred Qualifications:

  • MA/MS in Health or Nursing is preferred.
  • State-specific certification may be required in accordance with laws and contracts.
  • Willingness to travel to various work sites as necessary.

Job Level:

Non-Management Non-Exempt

Job Family:

MED > Licensed Nurse

About Elevance Health:

Elevance Health is committed to improving lives and communities within the healthcare sector. As a Fortune 25 company with a longstanding history in the industry, we seek dedicated professionals who aspire to make a meaningful impact on our members' lives.

Our Work Culture:

At Elevance Health, we cultivate a culture that emphasizes strategic focus and supports personal and professional development for our team members. Our core values guide our organizational culture, driving us toward shared success.

We offer a range of competitive benefits, including merit increases, paid holidays, Paid Time Off, incentive programs, comprehensive medical, dental, and vision plans, 401(k) with matching contributions, stock purchase options, life insurance, wellness initiatives, and financial education resources.

Elevance Health adheres to a Hybrid Workforce Strategy, with most associates working on-site at least once a week. Candidates should reside within a reasonable commuting distance to an Elevance Health location.

Compliance with COVID-19 vaccination requirements is mandatory for new hires in specific patient/member-facing roles. Elevance Health is an Equal Employment Opportunity employer, providing equitable opportunities to all applicants.

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