LTSS Service Coordinator-RN Clinician (RN Case Manager-Asheville Area)

Elevance Health; Asheville (NC); On-site; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking a dedicated LTSS Service Coordinator-RN Clinician to enhance the quality of care for members in the Asheville area. This role involves managing cases for individuals with chronic illnesses and disabilities, providing direction to LPNs, and collaborating with healthcare teams to develop tailored care plans. The ideal candidate will have a strong background in case management and a passion for improving patient outcomes. Join this innovative firm to make a meaningful impact in the lives of those you serve while enjoying a supportive work environment that values your expertise and commitment.

Qualifications

• 3+ years of experience with chronic illnesses or disabilities in a service coordination role.
• Active RN license required for the position.

Responsibilities

• Develop and monitor care plans to optimize member health care.
• Coordinate care for high-risk members with chronic illnesses.

Skills

Case Management

Clinical Assessments

Care Coordination

Communication Skills

Patient Advocacy

Education

High School Diploma or GED

Active RN License

MA/MS in Health/Nursing

Job description

Join to apply for the LTSS Service Coordinator-RN Clinician (RN Case Manager-Asheville Area) role at Elevance Health.

Location: Field associates spend 4-5 days per week in-person with patients, members or providers in the Henderson, Buncombe, and surrounding counties of North Carolina.

The RN Case Manager (also called LTSS Service Coordinator-RN Clinician) is responsible for the overall management of a member's case within the scope of licensure. They provide supervision and direction to non-RN clinicians involved in the member's case, develop, monitor, evaluate, and revise the care plan to meet the member's needs, with the goal of optimizing health care across the continuum.

How You Will Make An Impact

• Provide direction to LPN clinicians participating in the member's case in accordance with applicable state law and contract.
• Develop, monitor, evaluate, and revise the member's care plan to meet their needs and optimize health care across the continuum.
• Perform telephonic or face-to-face clinical assessments to evaluate and coordinate the member's physical health, behavioral health, social services, and long-term supports.
• Identify high-risk members and coordinate care with the member and healthcare team.
• Manage members with chronic illnesses, co-morbidities, and disabilities to ensure cost-effective and efficient utilization of benefits.
• Obtain thorough and accurate member histories to develop individualized care plans.
• Establish short and long-term goals collaboratively with members, caregivers, and physicians.
• Identify members who could benefit from alternative care levels or waiver programs.
• Develop and ensure access to services within the member's benefits, facilitating authorizations and referrals as appropriate.
• Collaborate with Medical Directors, Physician Advisors, and interdisciplinary teams on care management plans.

Minimum Requirements

• High school diploma or GED and at least 3 years of experience working with individuals with chronic illnesses, co-morbidities, or disabilities in a service coordination or similar role, or equivalent education and experience.
• Active, valid RN license in applicable state(s).

Preferred Skills and Experience

• MA/MS in Health/Nursing preferred.
• State-specific certification may be required and is preferred.
• Willingness to travel as needed.
• Experience working with older adults in care management or related roles is highly preferred.
• Experience managing community or facility-based care management caseloads is highly preferred.