LTSS Service Coordinator-RN Clinician - Clinical Nurse Coordinator
Company: Elevance Health
Location: Springfield
Posted on: April 15, 2024
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Job Description:
LTSS Service Coordinator-RN Clinician
Description
This is a field position and the candidate should reside in
Arlington, Alexandria, Falls Church, Springfield, and Fairfax.
The LTSS Service Coordinator RN Clinician is responsible for
overall management of member's case within the scope of licensure;
provides supervision and direction to non-RN clinicians
participating in the member's case in accordance with applicable
state law and contract; develops, monitors, evaluates, and revises
the member's care plan to meet the member's needs, with the goal of
optimizing member health care across the care continuum.
Responsible for performing face-to-face clinical 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.
Primary duties may include, but are not limited to:
* Identifies members for high risk complications and coordinates
care in conjunction with the member and the health care team.
* Manages members with chronic illnesses, co-morbidities, and/or
disabilities, to insure 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.
* The RN has overall responsibility to develop the care plan for
services for the member and ensures the member's access to those
services.
* May assist with the 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.
* Interfaces with Medical Directors, Physician Advisors and/or
Inter-Disciplinary Teams on the development of care management
treatment plans.
* May also assist in 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 by, for example, assigning
appropriate tasks to the non-RN clinicians, verifying and
interpreting member information obtained by these individuals,
conducting additional assessments, as necessary, to develop,
monitor, evaluate, and revise the member's care plan to meet the
member's needs, and reviewing and providing input on the non-RN
clinicians' performance on a regular basis.
Minimum 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.
Please be advised that Elevance Health only accepts resumes for
compensation from agencies that have a signed agreement with
Elevance Health. Any unsolicited resumes, including those submitted
to hiring managers, are deemed to be the property of Elevance
Health.
Who We Are
Elevance Health is a health company dedicated to improving lives
and communities - and making healthcare simpler. We are a Fortune
25 company with a longstanding history in the healthcare industry,
looking for leaders at all levels of the organization who are
passionate about making an impact on our members and the
communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to
advance our strategy but will also lead to personal and
professional growth for our associates. Our values and behaviors
are the root of our culture. They are how we achieve our strategy,
power our business outcomes and drive our shared success - for our
consumers, our associates, our communities and our business.
We offer 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.
Elevance Health operates in a Hybrid Workforce Strategy. Unless
specified as primarily virtual by the hiring manager, associates
are required to work at an Elevance Health location at least once
per week, and potentially several times per week. Specific
requirements and expectations for time onsite will be discussed as
part of the hiring process. Candidates must reside within 50 miles
or 1-hour commute each way of a relevant Elevance Health
location.
The health of our associates and communities is a top priority for
Elevance Health. We require all new candidates in certain
patient/member-facing roles to become vaccinated against COVID-19.
If you are not vaccinated, your offer will be rescinded unless you
provide an acceptable explanation. Elevance Health will also follow
all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all
qualified applicants will receive consideration for employment
without regard to age, citizenship status, color, creed,
disability, ethnicity, genetic information, gender (including
gender identity and gender expression), marital status, national
origin, race, religion, sex, sexual orientation, veteran status or
any other status or condition protected by applicable federal,
state, or local laws. Applicants who require accommodation to
participate in the job application process may contact
assistance.
Keywords: Elevance Health, Westfield , LTSS Service Coordinator-RN Clinician - Clinical Nurse Coordinator, Healthcare , Springfield, Massachusetts
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