LTSS Service Coordinator - RN Clinician

Elevance Health•Jeffersonville, IN

1d•Hybrid

About The Position

The LTSS Service Coordinator-RN Clinician is responsible for the overall management of a member's case within the scope of licensure. This role involves developing, monitoring, evaluating, and revising the member's care plan to meet their needs, with a focus on person-centered thinking and optimizing healthcare across the care continuum. This is a field-based role that requires travel to client sites or designated locations, with occasional office attendance for meetings or training. Candidates must be located in Clark, Floyd, or Washington County, Indiana, and must be within a reasonable commuting distance to the posting location.

Requirements

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; or any combination of education and experience which would provide an equivalent background.
Current, active, valid, and unrestricted RN license in applicable state(s).

Nice To Haves

BA/BS in Health/Nursing preferred.
Strong preference for case management experience with older adults or individuals with disabilities.

Responsibilities

Performing telephonic and face-to-face functional assessments for identification, evaluation, coordination, and management of member's needs, including physical health, behavioral health, social services, and long-term services and supports.
Identifying members at high risk for complications and coordinating care in conjunction with the member and the healthcare team.
Managing members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost-effective and efficient utilization of health benefits.
Obtaining a thorough and accurate member history to develop an individual care plan.
Establishing short and long-term goals in collaboration with the member, caregivers, family, natural supports, and physicians.
Identifying members who would benefit from an alternative level of care or other waiver programs.
Developing the care plan for services for the member and ensuring the member's access to those services.
Assisting with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within the benefits structure or through extra-contractual arrangements, as permissible.
Interfacing with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on the development of care management of person-centered care plans.
Assisting in problem-solving with providers, claims, or service issues.