LTSS Service Coordinator (Woodbury County, IA)

Elevance Health•Sioux City, IA

10d•Hybrid

About The Position

The LTSS Service Coordinator conducts service coordination for a defined caseload of individuals in specialized programs. In collaboration with each person supported, the coordinator facilitates Person Centered Planning to document the member’s preferences, needs, and self-identified goals. This includes conducting assessments, developing a comprehensive Person Centered Support Plan (PCSP) and backup plan, interfacing with Medical Directors, and participating in interdisciplinary care rounds to support an integrated care plan. The role engages the member’s circle of support and coordinates management of physical health, behavioral health, and long-term services and supports (LTSS) needs in accordance with applicable state law, contract, and federal requirements. This is a field-based role. The candidate should reside in Woodbury County, Iowa, and travel to client sites or designated locations as needed, with occasional office attendance for meetings or training. Alternate locations may be considered when within commuting distance of an office. Candidates outside a reasonable commuting distance from the posting location may not be considered unless an accommodation is granted as required by law.

Requirements

Bachelor of Arts or Bachelor of Science degree.
At least 2 years of experience working with a social work agency, or an equivalent combination of education and experience.
Specific education, years, and type of experience may be required based on state law and contract requirements.
Candidate should reside in Woodbury County, Iowa.
Travel to the worksite and other locations as necessary.

Nice To Haves

Bachelor of Arts or Bachelor of Science degree in a healthcare-related field.

Responsibilities

Conduct face-to-face program assessments using tools with predefined questions to identify needs, and use motivational interviewing techniques for evaluations, coordination, and management of waiver and behavioral or physical health needs.
Identify members with potential clinical healthcare needs, including high-risk complications and gaps in care, and coordinate their cases with the clinical healthcare management and interdisciplinary team as the single point of contact.
Manage members’ non-clinical needs related to chronic illnesses, co-morbidities, and disabilities to support cost-effective and efficient use of long-term services and supports.
Document members’ short- and long-term service and support goals in collaboration with the member and their chosen care team, which may include caregivers, family, natural supports, service providers, and physicians.
Identify members who may benefit from an alternative level of service or other waiver programs.
Submit utilization and authorization requests to utilization management with documentation that supports and aligns with the individual’s care plan.
Report critical incidents to appropriate internal and external parties, such as state and county agencies, Adult Protective Services, and law enforcement.
Assist with and participate in appeal or fair hearings, member grievances and appeals, and state audits.
May mentor, serve as a subject matter expert or preceptor for new staff, assist in formal associate training, and participate in process improvement initiatives.