LTSS Service Coordinator - RN Clinician (RN Case Manager)

Responsibilities

• Perform telephonic and face-to-face functional 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.
• May 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 of person-centered care plans.
• Assist in problem solving with providers, claims or service issues.

Requirements

• Requires a high school diploma or GED 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, which would provide an equivalent background.
• Current, active valid and unrestricted RN license in Ohio state(s) required.

Preferred Skills, Capabilities and Experiences

• Bachelor’s degree (BA/BS) in Health/Nursing preferred.
• Strong preference for case management experience with older adults or individuals with disabilities.

Benefits

• Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution.
• The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company.
• The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

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.

The MyCare Ohio health plan delivers high-quality, trauma-informed, culturally competent, person-centered coordination for all members that addresses physical health, behavioral health, long-term services and supports, and psychosocial needs.

The LTSS Service Coordinator-RN Clinician is responsible for overall management of member's case within the scope of licensure, developing, monitoring, evaluating, and revising the member's care plan to meet the member's needs, with the goal of prioritizing person-centered thinking and optimizing member health care across the care continuum.

For candidates working in person or virtually in the below locations, the salary range for this specific position is $36.38/hr to $45.48/hr.

Location(s): Columbus, OH

Additional benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level.

No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans.

The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.