CareBridge-posted 3 months ago
Full-time
Springfield, VA
251-500 employees
Ambulatory Health Care Services

The LTSS Service Coordinator RN Clinician is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Responsible for performing face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.

  • Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team.
  • Manages members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost effective and efficient utilization of health benefits.
  • Obtains a thorough and accurate member history to develop an individual care plan.
  • Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs.
  • Develops the care plan for services for the member and ensures the member's access to those services.
  • Assists with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate.
  • Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans.
  • Assists in problem solving with providers, claims or service issues.
  • Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals in coordinating services for the member.
  • Requires an RN and 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.
  • Current, unrestricted RN license in applicable state(s) required.
  • May require state-specified certification based on state law and/or contract.
  • MA/MS in Health/Nursing preferred.
  • Travels to worksite and other locations as necessary.
  • Merit increases
  • Paid holidays
  • Paid Time Off
  • Incentive bonus programs
  • Medical benefits
  • Dental benefits
  • Vision benefits
  • Short and long term disability benefits
  • 401(k) + match
  • Stock purchase plan
  • Life insurance
  • Wellness programs
  • Financial education resources
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