Family Care-Service Coordinator

Elevance Health•Waukesha, WI

3d•Hybrid

About The Position

The LTSS Service Coordinator (Case Manager) provides service coordination for a defined caseload of individuals enrolled in specialized programs, including Wisconsin’s Family Care Program. The role collaborates with each member to facilitate person-centered planning and document preferences, needs, and self-identified goals. This includes conducting assessments, developing a comprehensive Person Centered Support Plan (PCSP) and backup plan, coordinating with Medical Directors and interdisciplinary care teams, engaging the member’s circle of support, and managing physical health, behavioral health, and long-term services and supports needs in accordance with applicable requirements. This is a field-based role involving travel to client sites or other designated locations, with occasional office attendance for meetings or training. Candidates must live within a reasonable commuting distance of a posting location unless an accommodation is granted as required by law. Hiring is available in specified Wisconsin counties. The position may mentor or train new staff, contribute subject-matter expertise, and participate in process improvement initiatives. The listed anticipated end date is January 31, 2027.

Requirements

A BA/BS degree and at least 2 years of experience working with a social work agency, or an equivalent combination of education and experience.
Ability to travel to the worksite and other locations as necessary.

Nice To Haves

BA/BS degree in a healthcare-related field.
Assisted living or social work experience.
Waiver experience.
Comfort using technology.

Responsibilities

Conduct face-to-face program assessments using tools with predefined questions to identify member needs.
Use motivational interviewing techniques for evaluations, coordination, and management of members’ waiver, behavioral health, or physical health needs.
Identify members with potential clinical healthcare needs, including high-risk complications and gaps in care, and coordinate cases as the single point of contact with clinical healthcare management and the interdisciplinary team.
Manage members’ non-clinical needs related to chronic illnesses, co-morbidities, and disabilities to support efficient, cost-effective use of long-term services and supports.
Document short- and long-term service and support goals at the member’s direction and in collaboration with the member’s chosen care team.
Submit utilization and authorization requests with documentation aligned with the individual’s care plan.
Report critical incidents to appropriate internal and external parties, such as state and county agencies, Adult Protective Services, and law enforcement.
Assist with and participate in appeals or fair hearings, member grievances and appeals, and state audits.
May mentor, serve as a subject matter expert or preceptor for new staff, and assist with formal associate training.
May participate in process improvement initiatives.
Travel to the worksite and other locations as necessary.