LTSS Service Coordinator - Case Manager (Region B: Citrus/Duval/Hernando/Lake)

The Elevance Health Companies, Inc.

Miami (FL)

Hybride

USD 55 000 - 75 000

Plein temps

Il y a 6 jours
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Résumé du poste

Elevance Health is seeking a LTSS Service Coordinator to manage a defined caseload under LTSS/IDD programs, conducting assessments, building Person Centered Plans, and coordinating with medical and behavioral health teams. This role emphasizes field work across specified Florida regions with occasional office attendance.

Minimum BA/BS plus 2 years in social work; bilingual English/Spanish is strongly preferred.

Qualifications

  • Requires BA/BS degree and a minimum of 2 years of experience working with a social work agency.
  • Bilingual in English/Spanish strongly preferred.
  • LTSS, case management, social work or hospital discharge planning experience preferred.

Responsabilités

  • Conduct face-to-face program assessments and coordinate care plans for individuals in LTSS programs.
  • Serve as single point of contact across the member's care team and support inter-disciplinary collaboration.
  • Submit utilization/authorization requests and assist with state audits and appeals as needed.

Connaissances

Bilingual English/Spanish
Communication skills

Formation

BA/BS degree

Description du poste

Anticipated End Date: 2026-10-30 Position Title: LTSS Service Coordinator - Case Manager (Region B: Citrus/Duval/Hernando/Lake)

Schedule

Monday-Friday 8am-5pm EST

Location

This is primarily a field based position. Candidate would need to reside in one of the following counties: Alachua, Baker, Bradford, Clay, Citrus, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lake, Lafayette, Levy, Marion, Nassau, Putnam, St. John's, Sumter, Suwanee, Union, or Volusia County (Region B). Field: 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.

Hybrid/Virtual Work Policy

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.

Role Overview

The LTSS Service Coordinator is responsible for conducting service coordination functions for a defined caseload of individuals in specialized programs. 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.

Impact of the Role

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. Specific education, years, and type of experience may be required based upon state law and contract requirements.

Preferred Skills, Capabilities and Experiences

BA/BS degree field of study in health care related field preferred. Bilingual in English/ Spanish strongly preferred. LTSS, case management, social work or hospital discharge planning experience preferred.

Job Level

Non-Management

Non-Exempt Workshift

Job Family: MED > Medical Ops & Support (Non-Licensed)

Company Information

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Hybrid Workforce Strategy

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

COVID-19 and Influenza Vaccination Requirement

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.

Equal Employment Opportunity

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.

Accommodation and Fair Chance

Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form 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.

Equal Employment Opportunity Statement (Additional)

Elevance Health is an Equal Opportunity Employer/Disability/Veterans.

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