LTSS Svc Coord-RN Clinician

Elevance Health (Anthem); Nashville (TN); Híbrido; USD 70.000 - 90.000; Jornada completa

Descripción de la vacante

Elevance Health seeks a LTSS Service Coordinator - RN Clinician in Nashville, TN. This hybrid role requires in-office presence 1-2 days per week to foster collaboration while maintaining flexibility for productivity.

Responsibilities include telephonic and face-to-face functional assessments, developing and monitoring individual care plans, coordinating with the health care team, and ensuring access to services within benefits. RN licensure and relevant case management experience preferred.

Formación

• Requires a high school diploma or GED 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.
• Current, active valid and unrestricted RN license in Ohio state(s) required.
• BA/BS in Health/Nursing preferred.

Responsabilidades

• Perform telephonic and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs.
• Identify members for high risk complications and coordinate care with the member and health care team.
• Manage members with chronic illnesses to ensure cost-effective and efficient utilization of health benefits.
• Obtain thorough member history to develop an individual care plan.
• Establish short and long term goals with the member and caregivers, identifying needs for alternative levels of care or waiver programs.
• Develop the care plan for services for the member and ensure access to these services.

Conocimientos

Care coordination

Case management

Assessment

Educación

High school diploma or GED

RN license (Ohio)

BA/BS in Health/Nursing preferred

Descripción del empleo

Anticipated End Date

2027-01-31

Position Title

LTSS Svc Coord-RN Clinician

Job Description

LTSS Service Coordinator - RN Clinician (Case Manager)

This position is open to candidates located in Nashville and surrounding areas.

Hybrid 1 : This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

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 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.

Job Level

Non-Management Non-Exempt

Job Family

MED > Licensed Nurse

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.

Rewards

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 di