Elevance Health
LTSS Service Coordinator - Case Manager (Lee/Sarasota County)
Elevance Health, Venice, Florida, United States, 34292
LTSS Service Coordinator - Case Manager (Lee/Sarasota County)
Join to apply for the LTSS Service Coordinator - Case Manager (Lee/Sarasota County) role at Elevance Health.
Location : Glades, Hendry, Lee, or Sarasota County. This is primarily a field-based position. Candidate would need to reside in one of the following counties: Collier, Desoto, Glades, Hendry, Lee, or Sarasota County.
Field : 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. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.
Please note
that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Schedule : Monday-Friday 8am-5pm EST
Responsibilities
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, 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 individuals physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law and contract, and federal requirements.
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 and coordinates those members\' 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.
Specific education, years, and type of experience may be required based upon state law and contract requirements.
Preferred Skills, Capabilities And Experiences
Bilingual in English/ Spanish strongly preferred.
BA/BS degree field of study in health care related field preferred.
Long-term care experience preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Equal Opportunity 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.
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.
Elevance Health is a Fortune 25 company with a longstanding history in the healthcare industry, dedicated to improving lives and communities. We offer a range of market-competitive total rewards and a hybrid workforce strategy. Specific onsite expectations will be discussed during the hiring process. Vaccination requirements may apply for certain patient/member-facing roles, in line with federal, state, and local laws.
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Location : Glades, Hendry, Lee, or Sarasota County. This is primarily a field-based position. Candidate would need to reside in one of the following counties: Collier, Desoto, Glades, Hendry, Lee, or Sarasota County.
Field : 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. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.
Please note
that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
Schedule : Monday-Friday 8am-5pm EST
Responsibilities
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, 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 individuals physical health (PH)/behavioral health (BH)/LTSS needs, as required by applicable state law and contract, and federal requirements.
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 and coordinates those members\' 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.
Specific education, years, and type of experience may be required based upon state law and contract requirements.
Preferred Skills, Capabilities And Experiences
Bilingual in English/ Spanish strongly preferred.
BA/BS degree field of study in health care related field preferred.
Long-term care experience preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Equal Opportunity 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.
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.
Elevance Health is a Fortune 25 company with a longstanding history in the healthcare industry, dedicated to improving lives and communities. We offer a range of market-competitive total rewards and a hybrid workforce strategy. Specific onsite expectations will be discussed during the hiring process. Vaccination requirements may apply for certain patient/member-facing roles, in line with federal, state, and local laws.
#J-18808-Ljbffr