LTSS Service Coordinator (Case Manager)

Elevance Health; Mansfield (OH); Híbrido; USD 36.000 - 45.000; Jornada completa

Descripción de la vacante

Elevance Health seeks a LTSS Service Coordinator (Case Manager) to manage a designated caseload across Ohio, conducting person-centered planning and assessments to develop comprehensive PCSPs and backup plans. The role involves collaborating with Medical Directors and care teams to ensure integrated, compliant care, while engaging families and caregivers in the process.

You will monitor physical and behavioral health needs, coordinate long-term services, and support individuals in achieving

Formación

• BA/BS degree and at least 2 years in a social work setting.
• Preference for case management experience with older adults or individuals with disabilities.
• BA/BS in Health/Nursing preferred.

Responsabilidades

• Perform face-to-face program assessments using predefined questions and motivational interviewing to evaluate waiver needs.
• Identify members with potential clinical health care needs and coordinate cases with the interdisciplinary team.
• Manage non-clinical needs of members with chronic illnesses to ensure efficient use of long-term services and supports.
• Document member goals in collaboration with care teams and identify alternative service levels if needed.
• May mentor or precept new staff and participate in process improvement initiatives.
• Submit utilization/authorization requests with documentation aligned to care plans.
• Report critical incidents to appropriate agencies as required.
• Assist in appeals, grievances, state audits, and related processes.

Conocimientos

Case management

Assessments

Educación

BA/BS degree

2 years social work experience

Descripción del empleo

LTSS Service Coordinator (Case Manager)

Hiring statewide across Ohio. Must reside in the state of Ohio.

Location

This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands‑on engagement. . Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The MyCare Ohio health plan is to deliver high‑quality, trauma informed, culturally competent, person‑centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.

The LTSS Service Coordinator is responsible for managing service coordination for a designated caseload in specialized programs. Collaborate with individuals to lead the Person Centered Planning process, documenting their preferences, needs, and goals. Conduct assessments, create comprehensive Person Centered Support Plans (PCSP), and develop backup plans. Work with Medical Directors and partake in interdisciplinary care rounds to establish a fully integrated care plan. Engage the individual's support network and oversee management of their physical health, behavioral health, and long‑term services and supports, adhering to state and federal regulations.

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 Requirements

• Requires 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

• Strong preference for case management experience with older adults or individuals with disabilities.
• BA/BS in Health/Nursing preferred.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $26.19/hr to $32.75/hr

Location(s): Columbus, OH

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company’s sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

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 and Influenza. 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 should submit the Accessibility Accommodation Request Form (https://forms.cloud.microsoft/pages/responsepage.aspx?id=8giMvgesLESaRuvu61vU17EJaA0EP3FIissI8zmZ_NpUNUgyTFRUMkY5NE5JNDFWMkhaUzQxMkJLWS4u&route=shorturl) and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration (https://info.flclearinghouse.com/).