LTSS Service Coordinator - Case Manager (Region C: Pasco/Pinellas)

About the role

This is primarily a field based position. Candidate would need to reside in one of the following counties: Pasco or Pinellas County. Field: This field-based role enables 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. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.

Responsibilities

• Conducts service coordination functions for a defined caseload of individuals in specialized programs.
• Facilitates 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.
• Interfaces with Medical Directors and participates in interdisciplinary care rounds to support development of a fully integrated care plan.
• Engages the member’s circle of support and overall management of the individuals physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law and contract, and federal requirements.
• Manages 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.
• Documents their 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.
• Identifies members that would benefit from an alternative level of service or other waiver programs.
• Serves 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.
• Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individual’s care plan.
• Reports critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
• Assists and participates 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 strongly preferred.
• Ltss, case management, social work or hospital discharge planning experience preferred.

Benefits

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

At Elevance Health, 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.

Pay

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Schedule

Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week.