LTSS Service Coordinator - RN Clinician (Madison County, IN & Randolph County, IN)

About the role

The LTSS Service Coordinator - RN Clinician role is based in Madison County, IN or Randolph County, IN. This position involves field-based operations, primarily operating in the field with occasional office attendance for meetings or training.

Responsibilities

• Overall management of member's case within the scope of licensure.
• Provide direction and oversight 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 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.
• 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, monitor, evaluate, and revise the member's care plan to meet the member's needs.
• Ensure the member's access to services within the 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.
• Assign appropriate tasks to the non-RN clinicians, verify and interpret member information, conduct additional assessments as necessary, and review and provide input on the non-RN clinicians' performance on a regular basis.

Requirements

• High school 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.
• Experience working in a Service Coordinator, Case Management, or similar role.

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).
• The company provides medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources.

Pay

Details on pay are not specified in this job posting.

Schedule

Details on schedule are not specified in this job posting.