Field LTSS RN Care Coordinator – NC

Elevance Health; Raleigh (NC); Hybrid; USD 75,000 - 110,000; Full time

Benefits offered by this job

Health benefits

401(k) + match

Stock purchase plan

Life insurance

Job summary

Elevance Health is seeking a Field LTSS Service Coordinator RN Clinician to manage members' care across physical health, behavioral health, social services and long-term supports. This is a field-based role in Wake/Cumberland County, NC with travel to client sites and occasional office attendance for meetings or training.

Responsibilities include developing and monitoring individualized care plans, coordinating with the health care team, and ensuring access to required services within benefits

Qualifications

• Requires an RN with minimum 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.
• Current, unrestricted RN license in applicable state(s) required.
• May require state-specified certification based on state law and/or contract.

Responsibilities

• 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.

Skills

Care coordination

Field work

Travel readiness

Client relations

Education

RN License

3+ years chronic illness care

Job description

Elevance Health is seeking a Field LTSS Service Coordinator RN Clinician to manage members' care across physical health, behavioral health, social services and long-term supports. This is a field-based role in Wake/Cumberland County, NC with travel to client sites and occasional office attendance for meetings or training.

Responsibilities include developing and monitoring individualized care plans, coordinating with the health care team, and ensuring access to required services within benefits