Elevance Health
LTSS Service Coordinator - Case Manager (Pinellas County)
Elevance Health, Florida, New York, United States
LTSS Service Coordinator – Case Manager (Pinellas County)
Elevance Health is looking for a highly motivated LTSS Service Coordinator to serve our member community in Pinellas County. This field based role requires the coordinator to reside in Pinellas County and spend the majority of the time working directly onsite at client sites, with occasional office attendance for meetings or training.
Schedule: Monday‑Friday 8:00‑5:00 EST.
The LTSS Service Coordinator is responsible for conducting service coordination functions for a defined caseload of individuals in specialized programs. In collaboration with the person supported, the coordinator facilitates the Person Centered Planning process that documents the member’s preferences, needs and self‑identified goals, including but not limited to conducting assessments, development of a comprehensive Person Centered Support Plan (PCSP) and backup plan, interfacing with Medical Directors and participating in interdisciplinary care rounds to support development of a fully integrated care plan, engaging the member’s circle of support and overall management of the individual’s physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law and contract, and federal requirements.
How You Will Make an Impact
Perform face‑to‑face program assessments (using various tools with predefined questions) to identify, apply motivational interviewing techniques for evaluations, coordination, and management of an individual’s waiver (such as LTSS/IDD), and BH or PH needs.
Use tools and a predefined identification process to identify members with potential clinical health care needs and coordinate those member’s cases with the clinical health care management and interdisciplinary team in order to provide care coordination support.
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.
At the direction of the member, document 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.
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 of associates and participate in process improvement initiatives.
Submit utilization/authorization requests to utilization management with documentation supporting and aligning with the individual’s care plan.
Report critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
Assist and participate in appeal or fair hearings, member grievances, appeals, and state audits.
Minimum 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 that provides an equivalent background.
Specific education, years, and type of experience may be required based on state law and contract requirements.
Preferred Skills, Capabilities and Experiences
Bilingual in English/Spanish strongly preferred.
BA/BS degree in a health care related field preferred.
Long‑term care experience preferred.
Equal Employment Opportunity Statement Elevance Health operates as a hybrid workforce. Unless specified as primarily virtual, associates are required to work at an Elevance Health location at least once per week. All new candidates in certain patient/member‑facing roles must be vaccinated against COVID‑19 and Influenza; if not vaccinated, the offer will be rescinded unless an acceptable explanation is provided and Elevance Health will follow all relevant federal, state and local laws.
Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
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Schedule: Monday‑Friday 8:00‑5:00 EST.
The LTSS Service Coordinator is responsible for conducting service coordination functions for a defined caseload of individuals in specialized programs. In collaboration with the person supported, the coordinator facilitates the Person Centered Planning process that documents the member’s preferences, needs and self‑identified goals, including but not limited to conducting assessments, development of a comprehensive Person Centered Support Plan (PCSP) and backup plan, interfacing with Medical Directors and participating in interdisciplinary care rounds to support development of a fully integrated care plan, engaging the member’s circle of support and overall management of the individual’s physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law and contract, and federal requirements.
How You Will Make an Impact
Perform face‑to‑face program assessments (using various tools with predefined questions) to identify, apply motivational interviewing techniques for evaluations, coordination, and management of an individual’s waiver (such as LTSS/IDD), and BH or PH needs.
Use tools and a predefined identification process to identify members with potential clinical health care needs and coordinate those member’s cases with the clinical health care management and interdisciplinary team in order to provide care coordination support.
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.
At the direction of the member, document 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.
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 of associates and participate in process improvement initiatives.
Submit utilization/authorization requests to utilization management with documentation supporting and aligning with the individual’s care plan.
Report critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
Assist and participate in appeal or fair hearings, member grievances, appeals, and state audits.
Minimum 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 that provides an equivalent background.
Specific education, years, and type of experience may be required based on state law and contract requirements.
Preferred Skills, Capabilities and Experiences
Bilingual in English/Spanish strongly preferred.
BA/BS degree in a health care related field preferred.
Long‑term care experience preferred.
Equal Employment Opportunity Statement Elevance Health operates as a hybrid workforce. Unless specified as primarily virtual, associates are required to work at an Elevance Health location at least once per week. All new candidates in certain patient/member‑facing roles must be vaccinated against COVID‑19 and Influenza; if not vaccinated, the offer will be rescinded unless an acceptable explanation is provided and Elevance Health will follow all relevant federal, state and local laws.
Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including but not limited to the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
#J-18808-Ljbffr