LTSS Service Coordinator - RN Clinician (Middlesex County, NJ)

Elevance Health•Iselin, NJ

23h•Hybrid

About The Position

The LTSS Service Coordinator - RN Clinician manages members’ cases within the scope of RN licensure, providing direction and oversight to non-RN clinicians in accordance with applicable state law and contract requirements. The role develops, monitors, evaluates, and revises member care plans to address individual needs and optimize health care across the care continuum. It includes conducting telephonic or 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 role. The candidate should reside in Middlesex County, New Jersey; alternate locations may be considered for candidates within commuting distance of an office. The position requires travel to work sites and other locations as necessary, with occasional office attendance for meetings or training. Candidates outside a reasonable commuting distance from the posting location will not be considered unless an accommodation is granted as required by law. The position requires a current, active, valid, unrestricted RN license in the applicable state(s), and may require state-specified certification. The minimum education requirement is a high school diploma or equivalent. The position is classified as Non-Management, Non-Exempt. The New Jersey salary range is $41.84 to $62.76 per hour.

Requirements

High school diploma or equivalent.
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; an equivalent combination of education and experience may qualify.
Current, active, valid, and unrestricted RN license in the applicable state(s).
May require state-specified certification based on state law and/or contract.
Candidate should reside in Middlesex County, New Jersey, or an alternate location within commuting distance of an office.
Ability to travel to work sites and other locations as necessary.

Nice To Haves

Associate, MA, or MS degree in Health or Nursing preferred.

Responsibilities

Identify members at high risk for 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 a thorough and accurate member history and develop an individual care plan.
Establish short- and long-term goals collaboratively 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 or 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.
Provide direction and oversight to LPN/LVN, LSW, LCSW, LMSW, and other licensed non-RN professionals coordinating member services.
Assign appropriate tasks to non-RN clinicians, verify and interpret member information they obtain, conduct additional assessments as needed, and develop, monitor, evaluate, and revise member care plans.
Review and provide regular input on non-RN clinicians’ performance.
Travel to work sites and other locations as necessary.