LTSS Service Coordinator - Case Manager (Region C: Pasco/Pinellas)

Elevance Health•St. Petersburg, FL

7d•Onsite

About The Position

The LTSS Service Coordinator conducts service coordination for a defined caseload of individuals in specialized programs. Working collaboratively with each member, the coordinator facilitates person-centered planning to document preferences, needs, and self-identified goals. This includes completing assessments, developing a comprehensive Person Centered Support Plan (PCSP) and backup plan, interfacing with Medical Directors, participating in interdisciplinary care rounds, engaging the member’s circle of support, and coordinating physical health, behavioral health, and long-term services and supports needs as required by law, contract, and federal requirements. This is a primarily field-based role serving Pasco or Pinellas County, Florida. The coordinator travels to client sites or designated locations, with occasional office attendance for meetings or training. The schedule is Monday through Friday, 8 a.m. to 5 p.m. EST.

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.
Specific education, years, and type of experience may be required based on state law and contract requirements.
Bilingual proficiency in Spanish and English is specified for the role.

Nice To Haves

A BA/BS degree in a health care-related field.
Bilingual English/Spanish skills.
Experience in LTSS, case management, social work, or hospital discharge planning.

Responsibilities

Conduct face-to-face program assessments using tools with predefined questions, applying motivational interviewing techniques to evaluate, coordinate, and manage waiver, behavioral health, and physical health needs.
Identify members with potential clinical health care needs, including high-risk complications and gaps in care, and coordinate their cases as the single point of contact with clinical health care management and the interdisciplinary team.
Manage members’ non-clinical needs related to chronic illnesses, comorbidities, or disabilities to support cost-effective and efficient use of long-term services and supports.
Document members’ short- and long-term service and support goals in collaboration with the member’s chosen care team, which may include caregivers, family, natural supports, service providers, and physicians.
Identify members who may benefit from an alternative service level or other waiver programs.
Submit utilization and authorization requests with documentation that supports and aligns with the individual’s care plan.
Report critical incidents to appropriate internal and external parties, including state and county agencies.
Assist with and participate in appeal or fair hearings, member grievances and appeals, and state audits.
May mentor, serve as a subject matter expert or preceptor for new staff, assist with formal associate training, and participate in process improvement initiatives.