Managed Care Coordinator Clinician Non RN

2 weeks ago

Charleston, United States Elevance Health Full time

Managed Care Coordinator Clinician Non RN

Location: Remote, within 50 miles of an Elevance location

Shift: 10:30 am - 7 pm CST, with the possibility of a Saturday shift from 8 am - 2 pm CST.

The Managed Care Coordinator Clinician Non-RN is responsible for 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 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 community services and supports.

How you will make an impact:

  • Assists responsible RN in identifying members for high risk complications.

  • Obtains clinical data as directed by the responsible RN.

  • Assists the responsible RN in identifying members that would benefit from an alternative level of care or other waiver programs.

  • Provides all information collected to the responsible RN, who verifies and interprets the information, conducts additional assessments, as necessary, and develops, monitors, evaluates, and revises the members care plan to meet the members needs.

  • Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed by responsible RN, 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.

Minimum 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.

Preferred Skills, Capabilities and Experiences:

  • Compact Nursing License is strongly preferred.

  • May require state-specified certification based on state law and/or contract.

  • Experience using multiple screen

  • Excellent phone skills/etiquette- phone based role.

For candidates working in person or remotely in the below locations , the salary* range for this specific position is $29.24 to $52.62

Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

  • The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

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