LTSS Service Coordinator-RN Clinician at Elevance Health

Buffalo, New York, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Current, unrestricted RN license in applicable state(s)
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)
Reside in Buffalo and the surrounding area (within reasonable commuting distance; no hybrid/virtual unless accommodated by law)
Ability to travel to worksite, client sites, and other locations as necessary

Responsibilities

Manage overall member's case within scope of licensure, including developing, monitoring, evaluating, and revising the member's care plan to optimize health care across the care continuum
Provide supervision and direction to non-RN clinicians (e.g., LPN/LVN, LSW, LCSW, LMSW) participating in the member's case, per state law and contract, including assigning tasks, verifying information, conducting assessments, and reviewing performance
Perform telephonic or face-to-face clinical assessments to identify, evaluate, coordinate, and manage member's needs (physical health, behavioral health, social services, long-term services and supports)
Identify high-risk members 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 with short- and long-term goals in collaboration with member, caregivers, family, natural supports, and physicians
Identify members benefiting from alternative levels of care or waiver programs; ensure member's access to services
Assist with implementing care plans by facilitating authorizations/referrals for services within benefits 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

Skills

Key technologies and capabilities for this role

RNCase ManagementClinical AssessmentCare Plan DevelopmentTelephonic AssessmentFace-to-Face AssessmentChronic Illness ManagementCare CoordinationBehavioral HealthLong Term Services and Supports

Questions & Answers

Common questions about this position

Is this a remote position or does it require travel?

This is a field-based role where associates primarily operate in the field, traveling to client sites or designated locations, with occasional office attendance for meetings or training. Candidates must reside in Buffalo and the surrounding area, as those not within a reasonable commuting distance will not be considered unless an accommodation is granted.

What are the key responsibilities of the LTSS Service Coordinator - RN Clinician?

The role involves overall management of member's case within RN licensure scope, performing telephonic or face-to-face clinical assessments, developing and revising care plans, coordinating care for high-risk members with chronic illnesses, and supervising non-RN clinicians.

What qualifications are needed for this RN Clinician role?

Candidates must be a licensed RN, capable of managing cases within licensure scope, conducting clinical assessments, developing care plans, and supervising non-RN clinicians like LPNs and social workers.

What is the salary for this position?

This information is not specified in the job description.

What makes a strong candidate for this LTSS Service Coordinator role?

A strong candidate is an RN residing in Buffalo or surrounding areas, with experience in case management, clinical assessments, care plan development, and supervising non-RN clinicians for members with chronic illnesses or disabilities.

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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