LTSS Service Coordinator-RN Clinician at Elevance Health

Topeka, Kansas, United States

Elevance Health Logo
Not SpecifiedCompensation
Mid-level (3 to 4 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

  • High school diploma or GED equivalent
  • Minimum of 3 years of experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role (or equivalent combination of education and experience)
  • Current, active, valid, and unrestricted RN license in applicable state(s)

Responsibilities

  • Perform face-to-face clinical assessments for identification, evaluation, coordination, and management of member's needs, including physical health, behavioral health, social services, and long-term services and supports
  • Identify members at high risk for complications and coordinate care with the member and health care team
  • Manage members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost-effective and efficient utilization of health benefits
  • Obtain thorough and accurate member history to develop individual care plans, establishing short- and long-term goals in collaboration with member, caregivers, family, natural supports, and physicians
  • Identify members who would benefit from alternative levels of care or other waiver programs
  • Develop the care plan for member services and ensure member's access to those services
  • Provide overall management of member's case within scope of licensure
  • Provide direction and oversight to non-RN clinicians (e.g., LPN/LVN, LSW, LCSW, LMSW) by assigning tasks, verifying and interpreting member information, conducting additional assessments, developing/monitoring/evaluating/revising care plans, and reviewing performance
  • Assist with implementation of care plans by facilitating authorizations/referrals for services within benefits structure or extra-contractual arrangements
  • Interface with Medical Directors, Physician Advisors, and/or Interdisciplinary Teams on care management treatment plans
  • Assist in problem-solving with providers, claims, or service issues
  • Conduct member assessments in community residential settings for Kansas Medicaid Waivers (face-to-face, not telephonic), with travel using own vehicle; complete additional assessments as required by certain waivers

Skills

RN
Clinical Assessments
Care Coordination
Case Management
Medicaid Waivers
Care Planning
LTSS

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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