Field RN Clinician - LTSS Care Coordinator

elevancehealth; Indianapolis (IN); Hybrid; USD 75,000 - 110,000; Full time

Job summary

Elevance Health is seeking an LTSS Service Coordinator - RN Clinician to oversee member care plans and coordinate services across health, behavioral health, social services and long‑term supports in Lake County, IN. The role emphasizes telephonic and face‑to‑face assessments with field travel and collaboration with diverse care teams.

Qualified candidates will hold an active RN license, have 3+ years in chronic illness coordination, and be able to develop and monitor individualized care plans

Qualifications

• HS diploma or equivalent.
• Minimum of 3 years of experience working with individuals with chronic illnesses, co‑morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role.
• Current, active valid and 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.
• Provide direction and oversight to 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.

Education

HS diploma or equivalent

Associates/MA/MS in Health/Nursing

Job description

Elevance Health is seeking an LTSS Service Coordinator - RN Clinician to oversee member care plans and coordinate services across health, behavioral health, social services and long‑term supports in Lake County, IN. The role emphasizes telephonic and face‑to‑face assessments with field travel and collaboration with diverse care teams.

Qualified candidates will hold an active RN license, have 3+ years in chronic illness coordination, and be able to develop and monitor individualized care plans