Field-Based RN LTSS Care Navigator

Elevance Health; Columbus (OH); On-site; USD 50,000 - 76,000; Full time

Job summary

Elevance Health is seeking an LTSS Service Coordinator – RN Clinician (Case Manager) to operate in the field across Ohio counties including Richland, Franklin, Muskegum, Guernsey, Noble, Washington and Morgan.

The role focuses on creating and managing person-centered care plans for members with chronic illnesses, coordinating services and authorizations, and collaborating with medical directors and care teams.

Qualifications

• Requires a high school diploma or GED and 3 years of chronic illness/co-morbidity experience in a service coordination/case management role.
• Current, active RN license in Ohio.

Responsibilities

• Perform telephonic and face-to-face functional assessments to identify, evaluate, coordinate and manage member needs.
• Manage members with chronic illnesses to ensure cost-effective and efficient health benefit utilization.
• Obtain thorough member history to develop an individual care plan.
• Establish short and long-term goals with the member and caregivers; identify need for alternative care or waivers.
• Develop the member care plan and ensure access to services.
• Facilitate authorizations/referrals for service utilization within benefits or through applicable arrangements.
• Interface with Medical Directors and Inter-Disciplinary Teams on care management.

Skills

Telephonic assessments

Face-to-face assessments

Case management

RN license OH

Chronic illnesses experience

Education

High school diploma or GED

BA/BS in Health/Nursing preferred

Job description

Elevance Health is seeking an LTSS Service Coordinator – RN Clinician (Case Manager) to operate in the field across Ohio counties including Richland, Franklin, Muskegum, Guernsey, Noble, Washington and Morgan.

The role focuses on creating and managing person-centered care plans for members with chronic illnesses, coordinating services and authorizations, and collaborating with medical directors and care teams.