LTSS Service Coordinator (Case Manager)

About the role

This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training. Candidates must reside in the state of Ohio; alternate locations may be considered if within a reasonable commuting distance from an office. The role supports the MyCare Ohio health plan, delivering high-quality, trauma-informed, culturally competent, person-centered coordination for members addressing physical health, behavioral health, long-term services and supports, and psychosocial needs.

Responsibilities

• Manage service coordination for a designated caseload in specialized programs, leading the Person Centered Planning process and documenting member preferences, needs, and goals.
• Conduct assessments, create comprehensive Person Centered Support Plans (PCSP), and develop backup plans in collaboration with the member’s care team.
• Perform face-to-face program assessments using predefined tools and motivational interviewing techniques to evaluate and coordinate waiver (e.g., LTSS/IDD), behavioral health (BH), and physical health (PH) needs.
• Identify members with potential clinical healthcare needs, including high-risk complications or gaps in care, and serve as the single point of contact for care coordination with the interdisciplinary team.
• Manage non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost-effective and efficient utilization of long-term services and supports.
• Document short- and long-term service and support goals in collaboration with the member’s 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.
• Serve as a mentor, subject matter expert, or preceptor for new staff, assist in formal training, and participate in process improvement initiatives.
• Submit utilization/authorization requests to utilization management with documentation aligning with the individual’s care plan.
• Report critical incidents to appropriate internal and external parties, including state and county agencies (e.g., Adult Protective Services, Law Enforcement).
• Assist and participate in appeal or fair hearings, member grievances, and state audits.
• Collaborate with Medical Directors and participate in interdisciplinary care rounds to establish fully integrated care plans.
• Engage the individual’s support network and oversee management of their physical health, behavioral health, and long-term services and supports in adherence to state and federal regulations.

Requirements

• Requires a BA/BS degree and a minimum of 2 years of experience working with a social work agency; or any combination of education and experience providing an equivalent background.
• Strong preference for case management experience with older adults or individuals with disabilities.
• BA/BS in Health/Nursing preferred.

Pay

For candidates working in or virtually in Columbus, OH, the salary range for this position is $26.19/hr to $32.75/hr. The salary offered is based on legitimate, non-discriminatory factors such as geographic location, work experience, education, and skill level.

Benefits

• Comprehensive benefits package, including medical, dental, vision, short- and long-term disability, and 401(k) with company match.
• Incentive and recognition programs, equity stock purchase plan, and life insurance.
• Paid holidays, Paid Time Off (PTO), wellness programs, and financial education resources.

Schedule

Elevance Health operates under a Hybrid Workforce Strategy. Associates are required to work at an Elevance Health location at least once per week, with specific onsite expectations discussed during the hiring process.