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

Elevance Health•Iselin, NJ

10h•Onsite

About The Position

The LTSS Service Coordinator - RN Clinician manages a member’s case within the scope of RN licensure and provides direction and oversight to non-RN clinicians participating in the case, consistent with applicable state law and contract requirements. The role develops, monitors, evaluates, and revises member care plans to address needs and optimize health care across the care continuum. It includes telephonic and face-to-face clinical assessments to identify, evaluate, coordinate, and manage physical health, behavioral health, social service, and long-term services and supports needs. This is a field-based position. The candidate should reside in Hudson County, New Jersey; alternate locations may be considered if the candidate lives within commuting distance of an office. The role involves travel to client sites or other designated locations as required, with occasional office attendance for meetings or training. Candidates must be within a reasonable commuting distance of the posting location unless a legally required accommodation applies.

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, or an equivalent combination of education and experience.
Current, active, valid, and unrestricted RN license in applicable state(s).
State-specified certification may be required based on state law and/or contract.
Travel to the worksite and other locations as necessary.

Nice To Haves

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

Responsibilities

Identify members at risk for complications and coordinate care with the member and health care team.
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 to develop an individual care plan.
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 the member’s service care plan and ensure access to the services in it.
Facilitate service authorizations and referrals, as appropriate, within the benefits structure or through permissible extra-contractual arrangements.
Interface with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on care management treatment plans.
Assist with resolving provider, claims, or service issues.
Direct and oversee LPN/LVN, LSW, LCSW, LMSW, and other licensed non-RN professionals coordinating member services, including assigning tasks, verifying and interpreting information they obtain, conducting additional assessments as needed, and reviewing their performance.