LTSS Service Coordinator - RN Clinician (RN Case Manager) at Elevance Health

La Crosse, Wisconsin, United States

Elevance Health Logo
Not SpecifiedCompensation
Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

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

Responsibilities

  • Perform telephonic and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports
  • Identify members for high risk complications and coordinate care in conjunction with the member and the health care team
  • Manage members with chronic illnesses, co-morbidities, and/or disabilities to ensure cost effective and efficient utilization of health benefits
  • Obtain a thorough and accurate member history to develop an individual care plan
  • Establish short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identify members that would benefit from an alternative level of care or other waiver programs
  • Develop the care plan for services for the member and ensure the member's access to those services
  • Assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra-contractual arrangements, as permissible
  • Interface with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management of person-centered care plans
  • Assist in problem solving with providers, claims or service issues
  • Overall management of member's case within the scope of licensure, including developing, monitoring, evaluating, and revising the member's care plan to meet the member's needs, with the goal of prioritizing person-centered thinking and optimizing member health care across the care continuum

Skills

Key technologies and capabilities for this role

RNCase ManagementCare CoordinationFunctional AssessmentsCare PlanningTelephonic AssessmentsFace-to-Face AssessmentsChronic Illness ManagementBehavioral HealthLTSS

Questions & Answers

Common questions about this position

What is the work location and arrangement for this role?

This is a field-based role primarily operating in the field, traveling to client sites in Southwestern Wisconsin counties like Pepin, Buffalo, Trempealeau, and others, with occasional office attendance for meetings or training. Candidates must be within a reasonable commuting distance from the posting locations.

What are the minimum qualifications for this position?

The role requires a high school diploma or GED equivalent and a 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. It is specified for an RN Clinician, implying an active RN license.

What does the LTSS Service Coordinator - RN Clinician do day-to-day?

The role involves overall management of member's cases, performing telephonic and face-to-face functional assessments, developing and revising care plans, coordinating care with health teams, and ensuring access to services for members with chronic illnesses, co-morbidities, or disabilities.

Is this a remote or hybrid position?

No, it is a field-based role requiring travel to client sites in specified Wisconsin counties, with occasional office visits; candidates outside reasonable commuting distance will not be considered unless accommodated by law.

What experience makes a strong candidate for this RN Case Manager role?

Strong candidates will have at least 3 years of direct experience working with individuals with chronic illnesses, co-morbidities, or disabilities in service coordination or case management, along with RN licensure to manage care plans and perform assessments.

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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