LTSS Service Coordinator

About the role

This position serves Knox or Davidson and its surrounding counties in Tennessee. The role involves field-based operations, primarily operating in the field with occasional office attendance for meetings or training.

Responsibilities

• Conducts service coordination functions for a defined caseload of individuals in specialized programs.
• Facilitates the Person Centered Planning process, documenting the member's preferences, needs, and self-identified goals.
• Develops and implements a comprehensive Person Centered Support Plan (PCSP) and backup plan.
• Interacts with Medical Directors and participates in interdisciplinary care rounds to support the development of a fully integrated care plan.
• Engages the member's circle of support and manages the individual's physical health (PH) and behavioral health (BH) needs.
• Coordinates with clinical healthcare management and interdisciplinary teams to provide care coordination support.
• Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, ensuring cost-effective and efficient utilization of long-term services and supports.
• Documents short and long-term service and support goals in collaboration with the member's chosen care team.
• Identifies members that would benefit from alternative levels of service or other waiver programs.
• Serves as a mentor, subject matter expert, or preceptor for new staff, assisting in the formal training of associates.
• Serves as a single point of contact for utilization management, submitting authorization requests with documentation supporting the individual's care plan.
• Reports critical incidents to appropriate internal and external parties, including state and county agencies.
• Participates in appeal or fair hearings, member grievances, appeals, and state audits.

Requirements

• BA/BS degree in a health care-related field preferred.
• A minimum of 2 years of experience working with a social work agency.
• Travels to worksite and other locations as necessary.

Qualifications

• Requires BA/BS degree and a minimum of 2 years of experience working with a social work agency; or any combination of education and experience which would provide an equivalent background.

Skills

• Uses tools and pre-defined identification processes to identify members with potential clinical health care needs.
• Applies motivational interviewing techniques for evaluations and coordination of cases.
• Coordinates cases with the clinical healthcare management and interdisciplinary team to provide care coordination support.
• Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities.
• Documents short and long-term service and support goals in collaboration with the member's chosen care team.
• Identifies members that would benefit from alternative levels of service or other waiver programs.
• Serves as a mentor, subject matter expert, or preceptor for new staff, assisting in the formal training of associates.
• Serves as a single point of contact for utilization management, submitting authorization requests with documentation supporting the individual's care plan.
• Reports critical incidents to appropriate internal and external parties.
• Participates in appeal or fair hearings, member grievances, appeals, and state audits.

Benefits

• Market-competitive total rewards package including merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement).
• Medical, dental, and vision insurance.
• Short and long-term disability benefits.
• 401(k) +match.
• Stock purchase plan.
• Life insurance.
• Wellness programs and financial education resources.

Pay

Pay details are not specified in this job posting.

Schedule

Schedule details are not specified in this job posting.