LTSS Service Coordinator - RN Clinician (RN Case Manager)

Elevance Health • Neillsville, WI

77d

About The Position

The LTSS Service Coordinator-RN Clinician is responsible for overall management of member's case within the scope of licensure, develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of prioritizing person-centered thinking and optimizing member health care across the care continuum. 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.

Requirements

• Requires a high school diploma or GED equivalent.
• 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.
• Current, active valid and unrestricted RN license in applicable state(s) required.

Nice To Haves

• BA/BS in Health/Nursing preferred.
• Strong preference for case management experience with older adults or individuals with disabilities.
• Long Term Care background preferred.
• Commitment to member-centered care and cultural responsiveness.
• Family Care/Partnership experience preferred.
• Comfortable using technology preferred.
• Strong interpersonal and communication skills.
• Ability to work collaboratively in team environment.
• Problem solving and crisis management abilities.

Responsibilities

• Perform telephonic and face-to-face functional 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.
• Identify members for high risk complications and coordinate care in conjunction with the member and the health care team.
• Manage members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost effective and efficient utilization of health benefits.
• Obtain a thorough and accurate member history to develop an individual care plan.
• Establish short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians.
• Identify members that would benefit from an alternative level of care or other waiver programs.
• Develop the care plan for services for the member and ensure the member's access to those services.
• Assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services.
• Interface with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management of person-centered care plans.

Benefits

• Merit increases.
• Paid holidays.
• Paid Time Off.
• Incentive bonus programs.
• Medical, dental, vision benefits.
• Short and long term disability benefits.
• 401(k) + match.
• Stock purchase plan.
• Life insurance.
• Wellness programs.
• Financial education resources.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees