LTSS Svc Coord-RN Clinician (US)-1

Elevance Health

114d

About The Position

The RN Case Manager (LTSS Service Coordinator- RN Clinician) is a field-based role primarily operating in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training. The RN Case Manager is responsible for the overall management of a member's case within the scope of licensure, providing direction and oversight to non-RN clinicians participating in the member's case in accordance with applicable state law and contract. The role involves developing, monitoring, evaluating, and revising the member's care plan to meet their needs, with the goal of optimizing member health care across the care continuum.

Requirements

• Requires a HS diploma or 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.
• Current, active valid and unrestricted RN license in applicable state(s) required.

Nice To Haves

• MA/MS in Health/Nursing preferred.
• Experience working with older adults in care management, provider or other capacity, highly preferred.
• Experience managing a community and/or facility-based care management case load, highly preferred.
• Experience with Technology Assisted Waiver, highly preferred.

Responsibilities

• Perform telephonic or face-to-face clinical assessments for the identification, evaluation, coordination, and management of member's needs.
• Identify members for high-risk complications and coordinate care in conjunction with the member and the health care team.
• Manage members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost-effective and efficient utilization 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 the member, caregivers, family, natural supports, and physicians.
• Identify members that would benefit from an alternative level of care or other waiver programs.
• Develop the care plan for services for the member and ensure the member's access to those services.
• Assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services.
• Interface with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on the development of care management treatment plans.
• Provide direction and oversight to LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals in coordinating services for the member.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, vision benefits
• Short and long term disability benefits
• 401(k) + match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees