RN Case Manager – LTSS Service Coordinator (Hybrid)

Elevance Health; Brentwood (TN); Hybrid; USD 65.000 - 90.000; Vollzeit

Zusammenfassung

Elevance Health seeks an LTSS Service Coordinator – RN Clinician to manage member cases, develop care plans, and coordinate services across the care continuum. The role combines in-office collaboration with hybrid work flexibility.

Responsibilities include functional assessments, chronic illness management, and care plan implementation with attention to person-centered care and efficient use of health benefits.

Qualifikationen

• 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.

Aufgaben

• 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.
• Performs telephonic and face-to-face functional assessments for identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.
• 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.

Kenntnisse

RN license

Case management

Telephonic assessments

Face-to-face assessments

Chronic illness management

Ausbildung

High School Diploma or GED

BA/BS in Health/Nursing preferred

Jobbeschreibung

Elevance Health seeks an LTSS Service Coordinator – RN Clinician to manage member cases, develop care plans, and coordinate services across the care continuum. The role combines in-office collaboration with hybrid work flexibility.

Responsibilities include functional assessments, chronic illness management, and care plan implementation with attention to person-centered care and efficient use of health benefits.