LTSS Service Coordinator-RN Clinician

Elevance Health•Woodland Hills, CA

9d•Hybrid

About The Position

The LTSS Service Coordinator-RN Clinician manages members’ cases within the scope of RN licensure and supervises and directs non-RN clinicians participating in a member’s case, as allowed by applicable state law and contract. The role develops, monitors, evaluates, and revises member care plans to address member needs and optimize health care across the care continuum. It performs face-to-face clinical assessments to identify, evaluate, coordinate, and manage physical health, behavioral health, social service, and long-term services and supports needs. The position is open to candidates in Sacramento, Fresno, or Santa Clara, California. It follows a hybrid arrangement requiring 1–2 days per week in the office. Alternate locations may be considered for candidates within commuting distance of an office; candidates outside a reasonable commuting distance generally will not be considered unless an accommodation is granted as required by law. Travel to the worksite and other locations is required as necessary. The stated pay range for this California position is $41.84–$52.30 per hour. Elevance Health offers a comprehensive benefits package, with benefits subject to eligibility requirements.

Requirements

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.
Ability to travel to the worksite and other locations as necessary.
Candidates must reside within reasonable commuting distance of an office, unless an accommodation is granted as required by law.

Nice To Haves

MA/MS in Health or Nursing preferred.

Responsibilities

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, accurate member histories and develop individual care plans.
Establish short- and long-term goals with members, caregivers, family, natural supports, and physicians.
Identify members who may benefit from an alternative level of care or other waiver programs.
Develop the member’s care plan for services and ensure the member has access to those services.
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/or Inter-Disciplinary Teams on care management treatment plans.
Help resolve provider, claims, or service issues as needed.
Direct and/or supervise non-RN clinicians, including assigning tasks, verifying and interpreting member information they obtain, conducting additional assessments as needed, and reviewing and providing input on their performance.
Monitor, evaluate, and revise member care plans to meet member needs.