Elevance Health - Indiana, PA
posted 8 days ago
Full-time - Entry Level
Indiana, PA
Insurance Carriers and Related Activities
About the position
The Case Manager- LCSW/LSW/LMSW/LMHC/LMFT (also called the LTSS Service Coordinator - Clinician) has overall responsibility for the member's case, as required by the IN PathWays for Aging program. This role contributes to the LTSS care coordination process by performing activities within the scope of licensure, including assisting with telephonic or face-to-face 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. Field associates spend 4-5 days per week in-person with patients, members, or providers.
Responsibilities
- 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 member's care plan to meet the member's 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.
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.
- 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.
Nice-to-haves
- Experience working with older adults in care management, provider or other capacity, highly preferred.
- Experience managing a community and/or facility-based care management case load, highly preferred.
- MA/MS in Health/Nursing preferred.
- Travels to worksite and other locations as necessary.
Benefits
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short and long term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
