LTSS Service Coordinator - RN Clinician (Tyler County)

About the role

The LTSS Service Coordinator - RN Clinician is responsible for managing members' cases, providing supervision to non-RN clinicians, developing and monitoring care plans, and ensuring member access to services.

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.
• 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.
• 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 with problem-solving with providers, claims, or service issues.
• Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member.

Requirements

• Requires an RN 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, 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

• MA/MS in Health/Nursing preferred.
• Travels to worksite and other locations as necessary.

Benefits

Includes 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 the job posting.

Schedule

Details on schedule are not specified in the job posting.