LTSS Service Coordinator - Clinician
About The Position
The LTSS Service Coordinator-Clinician is responsible for working under the direction/supervision of an RN, with overall responsibility for the member's case. As required by applicable state law and contract, the Clinician contributes to the LTSS care coordination process by performing activities within the scope of licensure including, for example, assisting the responsible RN with telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.
Requirements
- Requires an LPN/LVN, LSW, LCSW, or LMSW or license other than RN in accordance with applicable state law and Nursing Diploma or AS in Nursing or a related field and minimum of 2 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator or similar role; or any combination of education and experience, which would provide an equivalent background.
- Current, unrestricted LPN/LVN, LSW, LCSW, LMSW or license other than RN (as allowed by state law) in applicable state(s) required.
- May require state-specified certification based on state law and/or contract.
Nice To Haves
- MA/MS in Health/Nursing preferred.
- Travels to worksite and other locations as necessary.
Responsibilities
- Assists responsible RN in identifying members for high risk complications. Obtains clinical data as directed by the responsible RN.
- Assists the responsible RN in identifying members that would benefit from an alternative level of care or other waiver programs.
- Provides all information collected to the responsible RN, who verifies and interprets the information, conducts additional assessments, as necessary, and develops, monitors, evaluates, and revises the member's care plan to meet the member's needs.
- Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed by responsible RN, and in conjunction with the RN, member and the health care team, to ensure cost effective and efficient utilization of health benefits.
- Decision making skills will be based upon the current needs of the member and require an understanding of disease processes and terminology and the application of clinical guidelines but do not require nursing judgment.
Benefits
- We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Industry
Insurance Carriers and Related Activities
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
