LTSS Service Coordinator at Elevance Health

Waukesha, Wisconsin, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

BA/BS degree and a minimum of 2 years of experience working with a social work agency; or any combination of education and experience which would provide an equivalent background
Ability to travel to worksite and other locations as necessary (field-based role; candidates not within reasonable commuting distance from Milwaukee County will not be considered unless accommodation granted)

Responsibilities

Conduct service coordination functions for a defined caseload of individuals in specialized programs
Facilitate the Person Centered Planning process, including conducting assessments, developing comprehensive Person Centered Support Plan (PCSP) and backup plan
Interface with Medical Directors and participate in interdisciplinary care rounds to support fully integrated care plan development
Engage the member’s circle of support and manage the individual’s physical health (PH)/behavioral health (BH)/LTSS needs per state law, contract, and federal requirements
Perform face-to-face program assessments using various tools and motivational interviewing techniques for identification, evaluation, coordination, and management of waiver, BH, or PH needs
Identify members with potential clinical health care needs (e.g., high-risk complications, gaps in care) using tools and pre-defined processes, and coordinate cases as single point of contact with clinical healthcare management and interdisciplinary team
Manage non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost-effective and efficient utilization of long-term services and supports
Document short- and long-term service and support goals in collaboration with the member’s chosen care team (e.g., caregivers, family, natural supports, service providers, physicians)
Serve as mentor, subject matter expert, or preceptor for new staff, assist in formal training, and participate in process improvement initiatives
Submit utilization/authorization requests to utilization management with supporting documentation aligned to the individual’s care plan
Report critical incidents to appropriate internal and external parties (e.g., state and county agencies like Adult Protective Services, Law Enforcement)
Assist and participate in appeals, fair hearings, member grievances, and state audits

Skills

Case Management

Motivational Interviewing

Person Centered Planning

Health Assessments

Care Coordination

Behavioral Health

Physical Health Management

LTSS

Waiver Programs

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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