Hybrid LTSS Service Coordinator – Case Manager

at Elevance Health

• Job title: LTSS Service Coordinator – Case Manager
• Job type: Full Time
• Experience level: Junior, Mid level
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Jacksonville, United States

About the role

• LTSS Service Coordinator handling service coordination for specialized programs. Conducting assessments and developing Person Centered Support Plans while engaging with individuals and their support teams.

Responsibilities

• Responsible for conducting service coordination functions for a defined caseload of individuals in specialized programs
• Facilitates the Person Centered Planning process that documents the member’s preferences, needs and self-identified goals
• Conducts assessments, development of a comprehensive Person Centered Support Plan (PCSP) and backup plan
• Interfaces with Medical Directors and participates in interdisciplinary care rounds to support development of a fully integrated care plan
• Engages the member’s circle of support and overall management of the individual's physical health (PH)/behavioral health (BH)/LTSS needs
• Performs face to face program assessments for identification, applying motivational interviewing techniques for evaluations, coordination, and management of an individual’s waiver needs
• Uses tools and pre-defined identification process to identify members with potential clinical health care needs
• Coordinates members’ cases with the clinical healthcare management and interdisciplinary team for care coordination support
• Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities
• Documents short and long-term service and support goals in collaboration with the member’s chosen care team
• Identifies members that would benefit from an alternative level of service or other waiver programs
• May also serve as mentor, subject matter expert or preceptor for new staff
• Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individual’s care plan
• Responsible for reporting critical incidents to appropriate parties such as state and county agencies
• Assists and participates in appeal or fair hearings, member grievances, appeals, and state audits

Requirements

• Requires BA/BS degree and a minimum of 2 years of experience working with a social work agency
• Specific education, years, and type of experience may be required based upon state law and contract requirements
• BA/BS degree field of study in health care related field preferred
• Bilingual in English/Spanish strongly preferred
• LTSS, case management, social work or hospital discharge planning experience preferred

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical benefits
• dental benefits
• vision benefits
• short and long term disability benefits
• 401(k) + match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources