LTSS Service Coordinator-RN Clinician

4 weeks ago

Jackson, Tennessee, United States Elevance Health Full time
Job Title: LTSS Service Coordinator-RN Clinician

At Elevance Health, we are seeking a highly skilled LTSS Service Coordinator-RN Clinician to join our team. As a key member of our team, you will be responsible for managing member cases within the scope of licensure, providing supervision and direction to non-RN clinicians, and developing, monitoring, evaluating, and revising care plans to meet member needs.

Key Responsibilities:
  • Perform telephonic or 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.
  • Obtain a thorough and accurate member history to develop an individual care plan.
  • Establish short and long-term goals in collaboration with the member, caregivers, family, natural supports, physicians, and identify members who would benefit from alternative levels of care or other waiver programs.
  • Develop and implement member care plans, ensuring member access to services, and facilitate authorizations/referrals for utilization of services within benefits structures or through extra-contractual arrangements.
  • Interface with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on the development of care management treatment plans.
  • Direct and/or supervise the work of LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals to coordinate services for members.
Requirements:
  • Requires an RN and 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.
Preferred Skills, Capabilities, and Experiences:
  • Proficiency in Microsoft Office (Excel, Word, Outlook, etc.) strongly preferred.
  • Case management experience strongly preferred.
  • Home health experience strongly preferred.
  • Medicaid experience strongly preferred.
  • Discharge planning experience strongly preferred.
  • MA/MS in Health/Nursing preferred.
  • May require state-specified certification based on state law and/or contract.
  • Travels to worksite and other locations as necessary.
Job Level:

Non-Management Non-Exempt

Workshift:

1st Shift (United States of America)

Job Family:

MED > Licensed Nurse

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