LTSS Service Coordinator - Case Manager (Region A: Bay/Escambia/Santa Rosa)

About the role

This is primarily a field based position. Candidate would need to reside in one of the following counties: Bay, Calchoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Leo, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Walkulla, Walton or Washington County. Field-based role enabling associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training.

Responsibilities

• Conduct service coordination functions for a defined caseload of individuals in specialized programs.
• Facilitate the Person Centered Planning process that documents the member's preferences, needs and self-identified goals, including but not limited to conducting assessments, development of a comprehensive Person Centered Support Plan (PCSP) and backup plan.
• Interface with Medical Directors and participate in interdisciplinary care rounds to support development of a fully integrated care plan.
• Engage the member's circle of support and overall manage the individuals physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law and contract, and federal requirements.
• 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 that may include, caregivers, family, natural supports, service providers, and physicians.
• Identify members that would benefit from an alternative level of service or other waiver programs.
• Serve as mentor, subject matter expert or preceptor for new staff, assisting in the formal training of associates, and may be involved in process improvement initiatives.
• Submit utilization/authorization requests to utilization management with documentation supporting and aligning with the individual's care plan.
• Report critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
• Assist and participate in appeal or fair hearings, member grievances, appeals, and state audits.

Requirements

• 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.

Preferred Skills, Capabilities and Experiences

• Bilingual in English/Spanish preferred.
• LTS, case management, social work or hospital discharge planning experience preferred.

Benefits

Market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Pay

Salary is commensurate with experience.

Schedule

Monday-Friday 8am-5pm EST

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

BA/BS degree field of study in health care related field preferred.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

We are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

Equal Opportunity Employer

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.