LTSS Service Coordinator - RN Telehealth

About the role

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. The approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates must reside in the tri-state area (NY, NJ, or CT). Per hybrid/virtual work policy, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment unless an accommodation is granted as required by law.

Responsibilities

• Perform telephonic clinical assessments for identification, evaluation, coordination, and management of members' 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 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, and 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 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 treatment plans.
• Assist in problem solving with providers, claims, or service issues.
• Direct and/or supervise the work of LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN in coordinating services for the member by assigning appropriate tasks, verifying and interpreting member information, conducting additional assessments, developing/monitoring/evaluating/revising the member's care plan, and reviewing non-RN clinicians' performance on a regular basis.

Requirements

• RN license required.
• 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.
• Current, unrestricted RN license in NY required.

Preferred Qualifications

• Bachelor's in Health/Nursing preferred.
• Bilingual in Spanish, Mandarin, or Cantonese highly preferred.
• May require state-specified certification based on state law and/or contract.
• CHHA and/or Medicare Experience preferred.

Pay

The salary range for this position is $41.84/hr to $62.76/hr for candidates working in person or virtually in New York.