LTSS Service Coordinator – RN Clinician, RN Case Manager
Elevance Health
full-time
Posted on:
Location Type: Hybrid
Location: Troy • Ohio • United States
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About the role
- Responsible for performing telephonic and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs
- 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
- The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services
- May assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible
- Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management of person-centered care plans
- May also assist in problem solving with providers, claims or service issues.
Requirements
- Requires a high school diploma or GED 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 Ohio state(s) required.
- BA/BS in Health/Nursing preferred.
- Strong preference for case management experience with older adults or individuals with disabilities.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
functional assessmentscare plan developmentchronic illness managementco-morbidity managementdisability managementutilization managementproblem solvingauthorizationsreferrals
Soft Skills
collaborationcommunicationcoordinationinterpersonal skillsgoal setting
Certifications
RN licenseGEDBA/BS in Health/Nursing