Elevance Health - Indiana, PA
posted 9 days ago
About the position
The LTSS SERVICE COORDINATOR is responsible for conducting service coordination functions for a defined caseload of individuals in the IN PathWays for Aging program. 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.
Responsibilities
- Perform face to face program assessments for identification, applying motivational interviewing techniques for evaluations, coordination, and management of an individual's waiver needs.
- Identify members with potential clinical health care needs and coordinate those member's cases with the clinical healthcare management and interdisciplinary team.
- Manage non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities.
- Document short and long-term service and support goals in collaboration with the member's chosen care team.
- Identify members that would benefit from an alternative level of service or other waiver programs.
- Serve as mentor, subject matter expert or preceptor for new staff, assisting in the formal training of associates.
- Submit utilization/authorization requests to utilization management with documentation supporting the individual's care plan.
- Report critical incidents to appropriate internal and external parties.
- Assist and participate in appeal or fair hearings, member grievances, appeals, and state audits.
Requirements
- BA/BS degree and a minimum of 2 years of experience working with a social work agency; or any combination of education and experience which would provide an equivalent background.
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
- BA/BS degree field of study in health care related field preferred.
- Willingness to travel 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
