LTSS Service Coordinator-Western Iowa at Elevance Health

Adel, Georgia, 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
Specific education, years, and type of experience may be required based upon state law and contract requirements
Ability to travel to worksite and other locations as necessary, including face-to-face meetings with patients in specified counties (e.g., Scott, Polk, Ida, Cherokee, etc.) in Western Iowa
Must be within a reasonable commuting distance from the posting location(s), unless an accommodation is granted as required by law

Responsibilities

Conduct service coordination functions for a defined caseload of individuals in specialized programs (e.g., LTSS/IDD)
Facilitate the Person Centered Planning process, including conducting assessments, developing comprehensive Person Centered Support Plan (PCSP) and backup plan
Interface with Medical Directors, participate in interdisciplinary care rounds, engage member’s circle of support, and manage physical health (PH)/behavioral health (BH)/LTSS needs per state law, contract, and federal requirements
Perform face-to-face program assessments using various tools and pre-defined questions, apply motivational interviewing techniques for evaluations, coordination, and management of waiver/BH/PH needs
Identify members with potential clinical health care needs (e.g., high-risk complications, gaps in care) using tools and pre-defined processes, and coordinate cases as the single point of contact with 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 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
Serve as mentor, subject matter expert, or preceptor for new staff, assist in formal training, and participate in process improvement initiatives
Submit utilization/authorization requests to utilization management with supporting documentation aligned with the individual’s care plan
Report critical incidents to appropriate internal and external parties (e.g., state and county agencies, Adult Protective Services, Law Enforcement)
Assist and participate in appeal or fair hearings, member grievances, appeals, and state audits

Skills

Service Coordination

Person Centered Planning

Motivational Interviewing

Program Assessments

Care Plan Development

Case Management

Interdisciplinary Care

Behavioral Health

Physical Health Management

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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