LTSS Service Coordinator – RN Clinician (RN Case Manager) Eastern Ohio

Elevance Health; Columbus (OH); On-site; USD 50,000 - 76,000; Full time

Job summary

Elevance Health is seeking an LTSS Service Coordinator – RN Clinician (Case Manager) to operate in the field across Ohio counties including Richland, Franklin, Muskegum, Guernsey, Noble, Washington and Morgan.

The role focuses on creating and managing person-centered care plans for members with chronic illnesses, coordinating services and authorizations, and collaborating with medical directors and care teams.

Qualifications

• Requires a high school diploma or GED and 3 years of chronic illness/co-morbidity experience in a service coordination/case management role.
• Current, active RN license in Ohio.

Responsibilities

• Perform telephonic and face-to-face functional assessments to identify, evaluate, coordinate and manage member needs.
• Manage members with chronic illnesses to ensure cost-effective and efficient health benefit utilization.
• Obtain thorough member history to develop an individual care plan.
• Establish short and long-term goals with the member and caregivers; identify need for alternative care or waivers.
• Develop the member care plan and ensure access to services.
• Facilitate authorizations/referrals for service utilization within benefits or through applicable arrangements.
• Interface with Medical Directors and Inter-Disciplinary Teams on care management.

Skills

Telephonic assessments

Face-to-face assessments

Case management

RN license OH

Chronic illnesses experience

Education

High school diploma or GED

BA/BS in Health/Nursing preferred

Job description

LTSS Service Coordinator – RN Clinician (Case Manager)

Hiring in the following counties:

• Richland

• Franklin

• Muskegum

• Guernsey

• Noble

• Washington

• Morgan

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-RN Clinician is responsible for overall management of member's case within the scope of licensure, develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of prioritizing person-centered thinking and optimizing member health care across the care continuum.

How you will make an impact:

• Responsible for performing telephonic and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports. 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 of person-centered care plans. May also assist in problem solving with providers, claims or service issues.

Minimum Requirements:

• Requires a high school diploma or GED equivalent and minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.

• Current, active valid and unrestricted RN license in Ohio state(s) required.

Preferred Skills, Capabilities and Experiences:

• BA/BS in Health/Nursing preferred.

• Strong preference for case management experience with older adults or individuals with disabilities.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $36.38/hr to $54.58/hr.

Location: 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 considered to be 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, paid time off, stock, 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.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

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.

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-faceting 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/).