LTSS Service Coordinator - RN Clinician (La Porte County, IN & Porter County, IN)

About the role

The LTSS Service Coordinator - RN Clinician position requires the candidate to reside in La Porte, IN or Porter County, IN. The role involves assisting with coverage for Lake County, Jasper County, Starke County, Pulaski County, La Porte County, and Porter County. The position is field-based, enabling associates to primarily operate in the field, with occasional office attendance for meetings or training.

Responsibilities

• Identifies members for high-risk complications and coordinates care in conjunction with the member and the health care team.
• Manages members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost-effective and efficient utilization of health benefits.
• Obtains a thorough and accurate member history to develop an individual care plan.
• 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, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.
• Performs telephonic or 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.
• Provides direction and oversight to non-RN clinicians participating in the member's case in accordance with applicable state law and contract.
• Interfaces with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on the development of care management treatment plans.
• Assists 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.
• Reviews and provides input on the non-RN clinicians' performance on a regular basis.

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.
• A current, active valid and 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

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

Benefits

Elevance Health offers a range of 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

Details on pay are not specified in this posting.

Schedule

Details on schedule are not specified in this posting.