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LTSS Service Coordinator Clinician

2 months ago

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

This is a field position and the candidate should reside in Loudon, Fairfax, or Prince William Counties VA.

Job Summary:

The LTSS Service Coordinator Clinician working under the direction/supervision of an RN, with overall responsibility for the member's case, as required by applicable state law and contract, contributes to the LTSS care coordination process by performing activities within the scope of licensure including, for example, assisting the responsible RN with telephonic assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.

Key Responsibilities:
  • Identifies members for high risk complications.
  • Obtains clinical data.
  • Identifies members that would benefit from an alternative level of care or other waiver programs.
  • Verifies and interprets information, conducts additional assessments, as necessary, and develops, monitors, evaluates, and revises the member's care plan to meet the member's needs.
  • Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities, and in conjunction with the RN, member and the health care team, to ensure cost effective and efficient utilization of health benefits.
  • Decision making skills will be based upon the current needs of the member and require an understanding of disease processes and terminology and the application of clinical guidelines but do not require nursing judgment.
Requirements:
  • Requires an LPN/LVN, LSW, LCSW, or LMSW or license other than RN in accordance with applicable state law and Nursing Diploma or AS in Nursing or a related field and minimum of 2 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator or similar role; or any combination of education and experience, which would provide an equivalent background.
  • Current, unrestricted LPN/LVN, LSW, LCSW, LMSW or license other than RN (as allowed by state law) in applicable state(s) required.
  • May require state-specified certification based on state law and/or contract.
Preferred Skills:
  • Previous experience with Utilization Management preferred.
  • Computer experience and experience using Microsoft Office Suite to include Outlook, Word, and Excel.
  • Travels to worksite and other locations as necessary.
Work Environment:

This is a field position and the candidate should reside in Loudon, Fairfax, or Prince William Counties VA.

About Elevance Health:

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. 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.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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.