LTSS Service Coordinator - RN Clinician

Houston, Texas, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must possess a valid Registered Nurse (RN) license, and a minimum of three years of experience working with individuals who have chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role.

Responsibilities

The LTSS Service Coordinator - RN Clinician is responsible for performing telephonic or face-to-face clinical assessments to identify and evaluate member needs, coordinating care across the continuum, developing and revising member care plans, managing members with chronic illnesses, and collaborating with healthcare teams to ensure optimal health outcomes. They will also establish short and long-term goals with members and caregivers, identify members needing alternative levels of care, and assist with implementing care plans by facilitating authorizations and referrals, while interfacing with Medical Directors and other teams to resolve provider and claims issues.

Skills

Clinical Assessment

Care Plan Development

Case Management

Chronic Illness Management

Behavioral Health

Social Services

Long Term Services and Supports (LTSS)

Utilization Management

Authorization Facilitation

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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