LTSS Service Coordinator - RN Clinician (Clark County, IN)

About the role

The LTSS Service Coordinator - RN Clinician role is primarily field-based, requiring travel to client sites or designated locations as needed. Candidates must reside in Clark County, IN and hold a current, active valid and unrestricted RN license in the applicable state(s).

Responsibilities

• Identifies members for high-risk complications and coordinates care.
• Manages members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost-effective and efficient utilization of health benefits.
• Develops, monitors, evaluates, and revises the member’s care plan to meet the member's needs.
• Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination, and management of member’s needs.
• Establishes short and long-term goals in collaboration with the member, caregivers, family, natural supports, physicians.
• Identifies members that would benefit from an alternative level of care or other waiver programs.
• Develops the care plan for services for the member and ensures the member's access to those services.
• Facilitates authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible.
• Interfaces with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on the development of care management treatment plans.
• Assists in problem-solving with providers, claims, or service issues.
• Provides direction and oversight to LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member.

Requirements

• HS diploma or equivalent.
• 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, which would provide an equivalent background.
• Current, active valid and unrestricted RN license in applicable state(s) required.

Qualifications

• Associates/MA/MS in Health/Nursing preferred.

Skills

• Ability to identify high-risk complications and coordinate care.
• Experience managing members with chronic illnesses, co-morbidities, and/or disabilities.
• Knowledge of developing, monitoring, evaluating, and revising care plans.
• Proficiency in performing clinical assessments.
• Collaboration skills with members, caregivers, family, natural supports, and physicians.
• Experience with authorizations/referrals and extra-contractual arrangements.
• Interpersonal skills to interface with Medical Directors, Physician Advisors, and Inter-Disciplinary Teams.
• Ability to oversee and guide non-RN clinicians.

Benefits

• Market-competitive total rewards package including merit increases, paid holidays, Paid Time Off, and incentive bonus programs.
• Medical, dental, vision, short and long-term disability benefits.
• 401(k) +match, stock purchase plan, life insurance, wellness programs, and financial education resources.

Pay

Compensation details are confidential and not specified in this posting.

Schedule

Work schedule details are confidential and not specified in this posting.