LTSS Service Coordinator - Community RN (UAS)

About the role

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. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates should reside in Brooklyn, Queens, Manhattan, Westchester, NY. Per hybrid/virtual work policy, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

Responsibilities

• Provide overall management of member's case within the scope of licensure.
• Provide supervision and direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract.
• Develop, monitor, evaluate, and revise the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.
• Perform face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.
• Identify members for high risk complications and coordinate care in conjunction with the member and the health care team.
• Manage members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost effective and efficient utilization of health benefits.
• Obtain a thorough and accurate member history to develop an individual care plan.
• Establish short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identify members that would benefit from an alternative level of care or other waiver programs.
• Develop the care plan for services for the member and ensure the member's access to those services.
• 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.
• Interface with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans.
• Assist in problem solving with providers, claims or service issues.
• Direct and/or supervise the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by assigning appropriate tasks, verifying and interpreting member information, conducting additional assessments, and reviewing performance on a regular basis.

Minimum Requirements

• High school diploma or equivalent and 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; or any combination of education and experience providing an equivalent background.
• Current, unrestricted RN license in applicable state(s) required.
• May require state-specified certification based on state law and/or contract.

Preferred Skills, Knowledge, and Experience

• MA/MS in Health/Nursing preferred.
• Travels to worksite and other locations as necessary.

Pay

For candidates working in person or virtually in New York, the salary range for this specific position is $41.84/hr to $62.76/hr.