LTSS Service Coordinator - Case Manager (Region H: Broward County)

Elevance Health•Lauderdale Lakes, FL

2d•Onsite

About The Position

The LTSS Service Coordinator is responsible for conducting service coordination functions for a defined caseload of individuals in specialized programs. In collaboration with the person supported, facilitates the Person Centered Planning process that documents the member’s preferences, needs and self-identified goals, including but not limited to conducting assessments, development of a comprehensive Person Centered Support Plan (PCSP) and backup plan, interfacing with Medical Directors and participating in interdisciplinary care rounds to support development of a fully integrated care plan, engaging the member’s circle of support and overall management of the individuals physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law and contract, and federal requirements. This is primarily a field-based position, requiring travel to client sites or designated locations, with occasional office attendance. Candidates must reside in Broward County or within a reasonable commuting distance.

Requirements

BA/BS degree and a minimum of 2 years of experience working with a social work agency.
Any combination of education and experience which would provide an equivalent background.
Specific education, years, and type of experience may be required based upon state law and contract requirements.

Nice To Haves

BA/BS degree field of study in a health care related field.
Bilingual in English/Spanish.
LTSS, case management, social work or hospital discharge planning experience.

Responsibilities

Performing face-to-face program assessments using various tools with pre-defined questions.
Applying motivational interviewing techniques for evaluations, coordination, and management of an individual’s waiver (such as LTSS/IDD), and BH or PH needs.
Identifying members with potential clinical healthcare needs and coordinating their cases with the clinical healthcare management and interdisciplinary team.
Managing 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.
Documenting short and long-term service and support goals in collaboration with the member’s chosen care team.
Identifying members that would benefit from an alternative level of service or other waiver programs.
Serving as a mentor, subject matter expert or preceptor for new staff, assisting in the formal training of associates.
Participating in process improvement initiatives.
Submitting utilization/authorization requests to utilization management with supporting documentation.
Reporting critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
Assisting and participating in appeal or fair hearings, member grievances, appeals, and state audits.