LTSS Service Coordinator-RN Clinician (Case Manager)

Elevance Health•Kansas City, KS

58d•Hybrid

About The Position

LTSS Service Coordinator-RN Clinician (Case Manager) Schedule: Monday-Friday 8am-5pm CST Location: Candidates must live in or near Wyandotte or Leavenworth County. Field: 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. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The LTSS Service Coordinator-RN Clinician is responsible for face-to-face member service coordination of all Kansas Medicaid Waivers, not telephonic. Member assessment of benefits is held in the community residential setting, requires travel and use of your own vehicle. The position works in collaboration with non-RN Medicaid Waiver coordinators. Some waivers have contractual requirements that will require an RN complete additional member assessment. This position is responsible for overall management of member's case within the scope of licensure. Provide direction and oversight to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.

Requirements

Requires a high school diploma or GED equivalent and minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.
Current, active valid and unrestricted RN license in applicable state(s) required.

Nice To Haves

MA/MS in Health/Nursing preferred.
May require state-specified certification based on state law and/or contract preferred.
Travels to worksite and other locations as necessary preferred.
KS HCBS Waiver experience preferred (TA and BI Waiver)

Responsibilities

Responsible for performing face-to-face clinical 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.
Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team.
Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits.
Obtains a thorough and accurate member history to develop an individual care plan.
Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs.
The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services.
May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible. Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans.
May also assist in problem solving with providers, claims or service issues.

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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