LTSS Svc Coord-Clinician

Elevance Health•Nashville, TN

13d•Hybrid

About The Position

The LTSS Service Coordinator-Clinician works under the direction and supervision of an RN, who retains overall responsibility for the member's case. As required by applicable state law and contract, the Clinician contributes to LTSS care coordination by performing activities within the scope of licensure. These activities may include assisting the responsible RN with telephonic or face-to-face assessments to identify, evaluate, coordinate, and manage member needs related to physical health, behavioral health, social services, and long-term services and supports. The Clinician assists the RN with gathering clinical information and identifying members who may be at risk of complications or who may benefit from an alternative level of care or other waiver programs. The RN verifies and interprets information, conducts any additional assessments, and develops, monitors, evaluates, and revises the member's care plan. The Clinician also participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed by the RN, working with the RN, member, and health care team to support cost-effective and efficient use of health benefits. Decision-making is based on the member's current needs and requires understanding disease processes, terminology, and clinical guidelines, but does not require nursing judgment. This hybrid role is open to candidates in Nashville and surrounding areas who are within a reasonable commuting distance of the posting location. Associates are expected to work in-office one to two days per week. The position is non-management and non-exempt.

Requirements

Current, unrestricted LPN/LVN, LSW, LCSW, LMSW, or other license permitted by applicable state law is required.
A Nursing Diploma, Associate of Science in Nursing, or a related field, and at least 2 years of experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator or similar role; or an equivalent combination of education and experience.
Understanding of disease processes and terminology and the ability to apply clinical guidelines; the role does not require nursing judgment.
Must be located within a reasonable commuting distance of the Nashville-area posting location unless an accommodation is granted as required by law.

Nice To Haves

Case management experience with older adults or individuals with disabilities is strongly preferred.
BA/BS in Health or Nursing is preferred.

Responsibilities

Assist the responsible RN in identifying members at risk for high-risk complications.
Obtain clinical data as directed by the responsible RN.
Assist the responsible RN in identifying members who may benefit from an alternative level of care or other waiver programs.
Provide collected information to the responsible RN for verification and interpretation, additional assessment as needed, and development, monitoring, evaluation, and revision of the member's care plan.
Participate in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed by the responsible RN.
Work with the RN, member, and health care team to support cost-effective and efficient utilization of health benefits.
Assist the responsible RN with telephonic or face-to-face assessments, within the scope of licensure, to identify, evaluate, coordinate, and manage member needs.