Elevance Health
LTSS Service Coordinator - Case Manager (Lee/Sarasota County)
Elevance Health, Arcadia, Florida, United States, 33821
LTSS Service Coordinator - Case Manager (Lee/Sarasota County)
Elevance Health is looking for a dedicated
LTSS Service Coordinator - Case Manager (Lee/Sarasota County)
to conduct service coordination functions for a defined caseload of individuals in specialized programs.
Location This is a field based position. Candidates must reside in one of the following counties: Collier, Desoto, Glades, Hendry, Lee, or Sarasota County.
Schedule Monday‑Friday 8:00 AM – 5:00 PM EST.
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 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 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.
EEO Statement 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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
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LTSS Service Coordinator - Case Manager (Lee/Sarasota County)
to conduct service coordination functions for a defined caseload of individuals in specialized programs.
Location This is a field based position. Candidates must reside in one of the following counties: Collier, Desoto, Glades, Hendry, Lee, or Sarasota County.
Schedule Monday‑Friday 8:00 AM – 5:00 PM EST.
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 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 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.
EEO Statement 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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
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