CareBridge
LTSS Service Coordinator (Case Manager)
Hire at
CareBridge
– state-wide across Ohio. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training.
The
MyCare Ohio health plan
delivers high-quality, trauma-informed, culturally competent, person-centered coordination for all members that addresses physical health, behavioral health, long-term services and supports, and psychosocial needs.
Responsibilities
Responsible for performing face-to-face program assessments (using various tools with pre-defined questions) for identification, applying motivational interviewing techniques for evaluations, coordination, and management of an individual's waiver (such as LTSS/IDD), and BH or PH needs.
Uses tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high-risk complications, addresses gaps in care) and coordinates those member's cases (serving as the single point of contact) with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
Manages 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.
At the direction of the member, documents their short and long-term service and support goals in collaboration with the member's chosen care team that may include, caregivers, family, natural supports, service providers, and physicians. 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, assisting in the formal training of associates, and may be involved in process improvement initiatives.
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 internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
Assists and participates in appeals or fair hearings, member grievances, appeals, and state audits.
Minimum Requirements
Requires 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.
Preferred Skills, Capabilities and Experiences
Strong preference for case management experience with older adults or individuals with disabilities.
BA/BS in Health/Nursing preferred.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.
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CareBridge
– state-wide across Ohio. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training.
The
MyCare Ohio health plan
delivers high-quality, trauma-informed, culturally competent, person-centered coordination for all members that addresses physical health, behavioral health, long-term services and supports, and psychosocial needs.
Responsibilities
Responsible for performing face-to-face program assessments (using various tools with pre-defined questions) for identification, applying motivational interviewing techniques for evaluations, coordination, and management of an individual's waiver (such as LTSS/IDD), and BH or PH needs.
Uses tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high-risk complications, addresses gaps in care) and coordinates those member's cases (serving as the single point of contact) with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
Manages 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.
At the direction of the member, documents their short and long-term service and support goals in collaboration with the member's chosen care team that may include, caregivers, family, natural supports, service providers, and physicians. 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, assisting in the formal training of associates, and may be involved in process improvement initiatives.
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 internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
Assists and participates in appeals or fair hearings, member grievances, appeals, and state audits.
Minimum Requirements
Requires 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.
Preferred Skills, Capabilities and Experiences
Strong preference for case management experience with older adults or individuals with disabilities.
BA/BS in Health/Nursing preferred.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.
#J-18808-Ljbffr