Family Care-Registered Nurse

Elevance Health•Waukesha, WI

3d•Hybrid

About The Position

The LTSS Service Coordinator - RN Clinician (RN Case Manager) manages members’ cases within the scope of RN licensure. The role develops, monitors, evaluates, and revises person-centered care plans to address member needs and optimize health care across the care continuum. The position supports Wisconsin’s Family Care Program, a long-term care program for older adults and adults with disabilities, with the goal of helping members live the lives they choose through supports that promote independent living, employment, and community participation. This is a field-based role serving members in designated Wisconsin counties. It involves travel to member homes and community locations for in-person visits, with occasional attendance at an office for meetings or training. Candidates must live within a reasonable commuting distance of an applicable office, unless an accommodation is granted as required by law. The position may also involve telephonic assessments and coordination with members, caregivers, families, providers, and interdisciplinary care teams.

Requirements

Associate of Science in Nursing or Bachelor of Science in Nursing, and at least 3 years of experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or an equivalent combination of education and experience.
Current, active, valid, unrestricted Wisconsin RN license.
At least 1 year of experience working with at least one of the Family Care target populations.
Ability to travel to worksites and other locations, including members’ homes and communities, for in-person visits.

Nice To Haves

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

Responsibilities

Conduct telephonic and face-to-face functional assessments to identify, evaluate, coordinate, and manage members’ physical health, behavioral health, social service, and long-term services and supports needs.
Identify members at risk of complications and coordinate care with members and their health care teams.
Manage members with chronic illnesses, co-morbidities, and/or disabilities to support cost-effective and efficient use of health benefits.
Obtain thorough and accurate member histories and develop individual care plans.
Collaborate with members, caregivers, family, natural supports, and physicians to establish short- and long-term goals.
Identify members who may benefit from an alternative level of care or other waiver programs.
Develop the member’s service care plan and ensure access to the services included in it.
As appropriate, facilitate authorizations and referrals for services within the benefits structure or through permissible extra-contractual arrangements.
Coordinate with Medical Directors, Physician Advisors, and interdisciplinary teams on person-centered care management plans.
Help resolve provider, claims, or service issues as needed.
Travel to worksites and other locations, including members’ homes and communities, for in-person visits.