LTSS Administration Service Coordinator - Lead (Region B)

Elevance Health•Jacksonville, FL

39d•Hybrid

About The Position

The LTSS Administration Service Coordinator - Lead is responsible for assisting management with day-to-day activities, such as monitoring and prioritizing workflow. Will perform reviews to ensure forms are completed accurately and timely. Assists in the development and maintenance of policies and procedures, training materials and job resources. Leads projects and participates in workgroups with cross-functional teams and serves as a representative on business unit and enterprise initiatives. Performs process evaluations and tests and monitors systems/process enhancements. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Requirements

Requires a BA/BS degree and a minimum of 2 years of experience working with a social work agency
Minimum of 5 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator or similar role
Any combination of education and experience which would provide an equivalent background.
Must be open to travel up to 2 hours away daily and reside in one of the following counties: Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St. Johns, Sumter, Suwanee, Union and Volusia.

Nice To Haves

Bilingual in Spanish/English
BA/BS degree field of study in healthcare related field preferred.
Specific education and years and type of experience may be required based upon state law and contract requirements.
Travels to worksite and other locations as necessary.

Responsibilities

Responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract; develops, monitors, and revises the member's service plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.
Responsible for performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's long-term service and support needs.
Using tools and a pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high-risk complications) and coordinates those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support. The process does not involve clinical judgment.
Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost-effective and efficient utilization of long-term services and supports.
Establishes short and long-term service and support goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of service or other waiver programs.
May also serve as a mentor or preceptor for new staff, assisting in the formal training of associates and may be involved in process improvement initiatives.
Assisting management with day-to-day activities, such as monitoring and prioritizing workflow.
Perform reviews to ensure forms are completed accurately and timely.
Assists in the development and maintenance of policies and procedures, training materials and job resources.
Leads projects and participates in workgroups with cross-functional teams and serves as a representative on business unit and enterprise initiatives.
Performs process evaluations and tests and monitors systems/process enhancements.