LTSS Service Coordinator (Case Manager) at Elevance Health

Indiana, 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
Must be within a reasonable commuting distance from Bartholomew County, Delaware County, Daviess County, Dubois County, Grant County, Greene County, Hancock County, Johnson County, Knox County, Martin County, Morgan County, Pike County, Shelby County, or Vigo County, Indiana (unless an accommodation is granted as required by law)

Responsibilities

Conduct service coordination functions for a defined caseload of individuals in the IN PathWays for Aging program
Facilitate the Person Centered Planning process, including conducting assessments, developing a comprehensive Person Centered Support Plan (PCSP) and backup plan
Interface with Medical Directors and participate in interdisciplinary care rounds to support development of a fully integrated care plan
Engage the member’s circle of support and manage the individual’s physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law, contract, and federal requirements
Perform face-to-face program assessments using various tools with pre-defined questions for identification, applying motivational interviewing techniques for evaluations, coordination, and management of an individual’s waiver (such as LTSS/IDD), BH, or PH needs
Use tools and pre-defined identification processes to identify members with potential clinical health care needs (e.g., high-risk complications, gaps in care) and coordinate their cases as the single point of contact with the 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 the member’s 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)
Identify members that would benefit from an alternative level of service or other waiver programs
Submit utilization/authorization requests to utilization management with documentation supporting and aligning with the individual’s care plan
Report critical incidents to appropriate internal and external parties (e.g., state and county agencies such as Adult Protective Services, Law Enforcement)
Assist and participate in appeal or fair hearings, member grievances, appeals, and state audits
May serve as mentor, subject matter expert, or preceptor for new staff, assist in formal training of associates, and be involved in process improvement initiatives

Skills

Case Management

Service Coordination

Person Centered Planning

Assessments

Care Planning

LTSS

Behavioral Health

Physical Health Management

Interdisciplinary Care

PCSP

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