STAR+PLUS LTSS Service Coordinator Level 1

Job Summary

The Star+Plus (LTSS) Service Coordinator Level 1 is responsible for managing member cases, providing supervision to non-RN clinicians, developing and monitoring care plans, and ensuring member access to services.

Responsibilities

• Perform clinical assessments and manage member needs, including physical health, behavioral health, social services, and long-term services and supports.
• Identify high-risk members and coordinate care with the member and healthcare team.
• Manage chronic illness cases and ensure cost-effective and efficient utilization of health benefits.
• Develop and monitor care plans, establish short- and long-term goals, and refer members to resources.
• Interface with medical directors, physician advisors, and interdisciplinary teams on care management treatment plans.
• Direct and supervise non-RN clinicians, verify and interpret member information, and provide input on their performance.
• Assist in meeting member needs by referring to internal and external resources and providing follow-up.
• Provide input and data for audits and serve as a mentor or subject matter expert.
• Participate in process improvement initiatives and problem-solving with providers, claims, or service issues.

Qualifications

• Current unrestricted RN license or NP in Texas required.
• Bachelor of Science in Nursing (BSN) preferred.
• 3-5 years nursing experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities.
• 1 year experience working with individuals receiving waiver services.
• 1 year experience working with persons with disabilities/chronic conditions and Long-Term Services & Supports.
• Proficiency in Microsoft Office and clinical documentation platforms.
• Reliable transportation with a valid driver's license and good driving record.