LTSS SVC COORD-CLINICIAN

Location: Nashville, Tennessee (Hybrid/Field-Based)

About The Role

Under the direction of a Registered Nurse (RN) and in accordance with applicable state regulations and contractual requirements, the LTSS Service Coordinator supports care coordination activities for members receiving Long-Term Services and Supports (LTSS). This role assists with member assessments, care coordination, and resource management while operating within the scope of licensure. The coordinator works closely with the responsible RN to support members with chronic illnesses, disabilities, co-morbidities, behavioral health needs, and social service needs.

Responsibilities

• Assist the RN with telephonic and face-to-face member assessments to identify and evaluate physical health, behavioral health, social service, and LTSS needs.
• Collect and document clinical information for review and interpretation by the responsible RN.
• Support identification of members at risk for complications and those who may benefit from alternative levels of care or waiver programs.
• Participate in coordinating care plans for members with chronic illnesses, disabilities, and complex healthcare needs.
• Collaborate with members, caregivers, providers, and interdisciplinary care teams to promote effective and efficient utilization of healthcare services.
• Monitor and communicate member needs, concerns, and changes in condition to the supervising RN.
• Assist with care coordination activities that support quality outcomes and member satisfaction.
• Maintain accurate and timely documentation in accordance with organizational, contractual, and regulatory requirements.
• Travel to member homes, provider offices, and other community locations as necessary.

Requirements

• Current, unrestricted licensure in Tennessee as one of the following:
  • Licensed Practical Nurse (LPN/LVN)
  • Licensed Social Worker (LSW)
  • Licensed Clinical Social Worker (LCSW)
  • Licensed Master Social Worker (LMSW)
  • Other non-RN license as permitted by state law
• Nursing Diploma, Associate Degree in Nursing, or degree in a related field.
• Minimum of 2 years of experience working with individuals with chronic illnesses, co-morbidities, disabilities, or complex healthcare needs in a Service Coordinator, Case Manager, Care Coordinator, or similar role.
• Knowledge of healthcare terminology, disease processes, and clinical guidelines.
• Ability to coordinate care and communicate effectively with members, providers, and interdisciplinary teams.
• Valid driver's license and ability to travel throughout the assigned service area.

Preferred Qualifications

• Master's degree in Health, Nursing, Social Work, or a related field.
• Experience with LTSS, Medicaid, managed care, or population health programs.
• State-specific certifications as required by applicable contracts or regulations.

Schedule

Monday–Friday, 8:00 AM–5:00 PM EST

Work Environment

• Hybrid/Field-Based Role
• Employees may work remotely as business needs allow but are expected to perform field-based responsibilities regularly.
• Requires 4–5 days per week conducting in-person visits with members, providers, and community resources throughout Tennessee.
• Travel is required to member homes, healthcare facilities, and other designated locations.
• May involve work in care centers, assisted living facilities, clinics, and member homes, including environments where medication access is present.