LTSS Service Coordinator - RN Telehealth

Elevance Health; Town of Colonie (NY); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading health services company is seeking an LTSS Service Coordinator - RN Telehealth to manage member cases and ensure quality care. The role involves telephonic assessments, care coordination for high-risk members, and developing individualized care plans. Candidates must have a current NY RN license and at least 3 years of relevant experience in a case management role. This position offers full-time virtual work with some required in-person training.

Qualifications

• Minimum of 3 years of experience in case management or similar role.
• Current, unrestricted RN license in NY required.

Responsibilities

• Perform telephonic clinical assessments for member's needs.
• Coordinate care for high-risk members with chronic illnesses.
• Develop and monitor individual care plans for members.

Skills

Telephonic clinical assessments

Care coordination

Experience with chronic illnesses

Bilingual (Spanish, Mandarin, or Korean)

Education

Bachelor's in Health/Nursing

Current RN license in NY

Job description

Position Title: LTSS Service Coordinator - RN Telehealth

Location: Candidate must reside in the tri-state area (NY, NJ, or CT).

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.

The LTSS Service Coordinator - RN Telehealth is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.

How you will make an impact:

• Responsible for performing telephonic clinical 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 treatment plans.
• May also assist in problem solving with providers, claims or service issues.
• Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member.

Minimum Requirements:

• Requires an RN 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, unrestricted RN license in NY required.

Preferred Skills, Capabilities, and Experiences:

• Bachelor's in Health/Nursing preferred.
• Bilingual in Spanish, Mandarin, or Korean highly preferred.
• May require state-specified certification based on state law and/or contract.
• CHHA and/or Medicare Experience Preferred.

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.