LTSS Service Coordinator – RN Clinician (RN Case Manager) Eastern Ohio

About the role

The MyCare Ohio health plan is to deliver 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 a member's case within the scope of licensure, develops, monitors, evaluates, and revises 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. This field‑based role requires associates to primarily operate in the field, traveling to client sites or designated locations as needed, with occasional office attendance for meetings or training. The position is hiring in the following counties: Richland, Franklin, Muskegum, Guernsey, Noble, Washington, and Morgan. Per the company's hybrid/virtual work policy, candidates not within a reasonable commuting distance from the posting location(s) will not be considered unless an accommodation is granted as required by law.

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.
• Assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, 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 of person‑centered care plans.
• Assist in problem solving with providers, claims or service issues.

Requirements

• High school diploma or GED equivalent and a minimum of 3 years of experience 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 that provides an equivalent background.
• Current, active, valid and unrestricted RN license in Ohio state(s) required.

Qualifications

• BA/BS in Health/Nursing preferred.
• Strong preference for case management experience with older adults or individuals with disabilities.

Benefits

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

Pay

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $36.38/hr to $54.58/hr. Location: Columbus, OH. 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. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be 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, paid time off, stock, 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.