LTSS Service Coordinator-RN Clinician

Elevance Health•Nashville, TN

9d•Hybrid

About The Position

The LTSS Service Coordinator-RN Clinician manages members’ cases within the scope of RN licensure, supervises and directs non-RN clinicians as permitted by state law and contract, and develops, monitors, evaluates, and revises care plans to meet member needs and optimize health care across the care continuum. The role includes face-to-face clinical assessments to identify, evaluate, coordinate, and manage members’ physical health, behavioral health, social service, and long-term services and supports needs. This is a field-based position open to candidates in Davidson and surrounding counties. The role involves travel to client sites or designated locations, with occasional office attendance for meetings or training. Alternate locations may be considered for candidates within commuting distance of an office. Candidates must be within a reasonable commuting distance of the posting location unless an accommodation is granted as required by law. The RN coordinates care for members at risk of complications and those with chronic illnesses, co-morbidities, or disabilities. The RN develops member-specific care plans, collaborates with members and their support networks and care teams, and helps ensure access to services. The position may also involve facilitating service authorizations and referrals, resolving provider or service issues, and directing or supervising non-RN clinicians who coordinate member services. Elevance Health describes itself as a health company dedicated to improving lives and communities and making healthcare simpler. Its stated total rewards include merit increases, paid holidays, paid time off, incentive bonus programs, medical, dental and vision coverage, short- and long-term disability benefits, a 401(k) with match, a stock purchase plan, life insurance, wellness programs, and financial education resources. The company operates a hybrid workforce strategy; associates are generally required to work at an Elevance Health location at least once per week unless the position is specified as primarily virtual. New candidates in certain patient- or member-facing roles must become vaccinated against COVID-19 and influenza unless they provide an acceptable explanation.

Requirements

Registered Nurse (RN) qualification and a current, unrestricted RN license in applicable state(s).
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.
May require state-specified certification based on state law and/or contract.
Must be located within a reasonable commuting distance of the posting location(s), unless an accommodation is granted as required by law.
Ability to travel to worksites and other locations as necessary.

Nice To Haves

MA/MS in Health or Nursing preferred.

Responsibilities

Identify members at risk for high-risk complications and coordinate care with members and the health care team.
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 individualized care plans.
Establish short- and long-term goals in collaboration with members, caregivers, family, natural supports, and physicians.
Identify members who may benefit from an alternative level of care or other waiver programs.
Develop care plans for member services and ensure members’ access to those services.
As appropriate, facilitate authorizations and referrals for services within the benefits structure or through permissible extra-contractual arrangements.
Interface with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams to develop care management treatment plans.
Assist with problem-solving provider, claims, or service issues.
Direct and/or supervise non-RN clinicians coordinating member services, including assigning tasks, verifying and interpreting information they obtain, conducting additional assessments as needed, and reviewing and providing input on their performance.
Travel to worksites and other locations as necessary.