LTSS Service Coordinator (Case Manager)

Elevance Health; Frankfort (IN); On-site; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a compassionate and skilled LTSS Service Coordinator to join their team. In this impactful role, you will conduct assessments and facilitate service coordination for individuals in the IN PathWays for Aging program. Your expertise will help develop comprehensive support plans that address the physical and behavioral health needs of members. You will engage with various stakeholders, including medical directors and support teams, to ensure efficient care management. If you are passionate about making a difference in the lives of older adults and have a strong background in care coordination, this opportunity is perfect for you.

Qualifications

• BA/BS degree with 2+ years experience in social work or equivalent.
• Experience with older adults in care management preferred.

Responsibilities

• Conduct assessments and manage care coordination for individuals.
• Document service goals and coordinate with interdisciplinary teams.

Skills

Motivational Interviewing

Care Coordination

Assessment Skills

Interdisciplinary Team Collaboration

Education

BA/BS Degree

Health Care Related Field

Tools

Assessment Tools

Job description

Location: Field associates spend 4-5 days per week in-person with patients, members or providers.

The LTSS SERVICE COORDINATOR is responsible for conducting service coordination functions for a defined caseload of individuals in the IN PathWays for Aging program. In collaboration with the person supported, facilitates the Person Centered Planning process that documents the member's preferences, needs and self-identified goals, including but not limited to conducting assessments, development of a comprehensive Person Centered Support Plan (PCSP) and backup plan, interfacing with Medical Directors and participating in interdisciplinary care rounds to support development of a fully integrated care plan, engaging the member's circle of support and overall management of the individuals physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law and contract, and federal requirements.

How you will make an impact

• Responsible for performing face to face program assessments (using various tools with pre-defined questions) for identification, applying motivational interviewing techniques for evaluations, coordination, and management of an individual's waiver (such as LTSS/IDD), and BH or PH needs.
• Uses tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high-risk complications, addresses gaps in care) and coordinates those member's cases (serving as the single point of contact) with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
• Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost effective and efficient utilization of long-term services and supports.
• At the direction of the member, documents their short and long-term service and support goals in collaboration with the member's chosen care team that may include, caregivers, family, natural supports, service providers, and physicians.
• Identifies members that would benefit from an alternative level of service or other waiver programs.
• May also serve as mentor, subject matter expert or preceptor for new staff, assisting in the formal training of associates, and may be involved in process improvement initiatives.
• Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individual's care plan.
• Responsible for reporting critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
• Assists and participates in appeal or fair hearings, member grievances, appeals, and state audits.

Minimum Qualifications:

• BA/BS degree and a minimum of 2 years of experience working with a social work agency; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Experience working with older adults in care management, provider or other capacity, highly preferred.
• Experience managing a community and/or facility-based care management case load, highly preferred.
• BA/BS degree field of study in health care related field preferred.
• Travels to worksite and other locations as necessary.

Job Level

Non-Management Non-Exempt

Workshift

Job Family

MED > Medical Ops & Support (Non-Licensed)