Elevance Health
Family Care-Registered Nurse
Elevance Health, Richland Center, Wisconsin, United States, 53581
LTSS Service Coordinator - RN Clinician (RN Case Manager)
$5,000 Sign-on Bonus
Hiring near Southwestern Wisconsin in counties: Pepin, Buffalo, Trempealeau, Jackson, Clark, La Crosse, Monroe, Juneau, Vernon, Sauk, Richland, Crawford, Grant, Iowa, Lafayette, Green.
Location:
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.
Anthem is very excited to be a managed care organization in western/southwestern Wisconsin and Milwaukee County to offer the Family Care Program. Family Care is a Wisconsin long‑term care program for older adults and adults with disabilities. Our goal is that each member will experience the life they choose with supports to maximize independent living, employment, and contributing to their communities.
LTSS Service Coordinator‑RN Clinician
is responsible for overall management of member's case within the scope of licensure, develops, monitors, evaluates, and revises the member’s care plan to meet the member’s needs, with the goal of prioritizing person‑centered thinking and optimizing member health care across the care continuum.
How You Will Make An Impact
Perform telephonic and face‑to‑face functional assessments for identification, evaluation, coordination and management of member’s needs, including physical health, behavioral health, social services, and long‑term services and supports. Identify members for high‑risk complications and coordinate care in conjunction with the member and the health care team.
Manage members with chronic illnesses, co‑morbidities, and/or disabilities, ensuring cost‑effective and efficient utilization of health benefits.
Obtain a thorough and accurate member history to develop an individual care plan.
Establish short and long‑term goals in collaboration with the member, caregivers, family, natural supports, physicians; identify members that would benefit from an alternative level of care or other waiver programs.
Develop the care plan for services for the member and ensure the member’s access to those services.
Assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra‑contractual arrangements, as permissible.
Interface with Medical Directors, Physician Advisors and/or Inter‑Disciplinary Teams on the development of care management of person‑centered care plans. May also assist in problem solving with providers, claims or service issues.
Minimum Requirements
Associate of Science in Nursing or Bachelor of Science in Nursing and minimum of 3 years of experience in working with individuals with chronic illnesses, co‑morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.
Current, active, valid and unrestricted RN license in Wisconsin is required.
Minimum of one year experience working with at least one of the Family Care target populations is required.
Preferred Skills, Capabilities and Experiences
BA/BS in Health/Nursing preferred.
Strong preference for case management experience with older adults or individuals with disabilities.
Long Term Care background preferred.
Commitment to member‑centered care and cultural responsiveness.
Family Care/Partnership experience preferred.
Comfortable using technology preferred.
Strong interpersonal and communication skills.
Ability to work collaboratively in team environment.
Problem solving and crisis management abilities.
Travels to worksite and other locations including members home/community for in‑person visits.
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.
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.
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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$5,000 Sign-on Bonus
Hiring near Southwestern Wisconsin in counties: Pepin, Buffalo, Trempealeau, Jackson, Clark, La Crosse, Monroe, Juneau, Vernon, Sauk, Richland, Crawford, Grant, Iowa, Lafayette, Green.
Location:
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.
Anthem is very excited to be a managed care organization in western/southwestern Wisconsin and Milwaukee County to offer the Family Care Program. Family Care is a Wisconsin long‑term care program for older adults and adults with disabilities. Our goal is that each member will experience the life they choose with supports to maximize independent living, employment, and contributing to their communities.
LTSS Service Coordinator‑RN Clinician
is responsible for overall management of member's case within the scope of licensure, develops, monitors, evaluates, and revises the member’s care plan to meet the member’s needs, with the goal of prioritizing person‑centered thinking and optimizing member health care across the care continuum.
How You Will Make An Impact
Perform telephonic and face‑to‑face functional assessments for identification, evaluation, coordination and management of member’s needs, including physical health, behavioral health, social services, and long‑term services and supports. Identify members for high‑risk complications and coordinate care in conjunction with the member and the health care team.
Manage members with chronic illnesses, co‑morbidities, and/or disabilities, ensuring cost‑effective and efficient utilization of health benefits.
Obtain a thorough and accurate member history to develop an individual care plan.
Establish short and long‑term goals in collaboration with the member, caregivers, family, natural supports, physicians; identify members that would benefit from an alternative level of care or other waiver programs.
Develop the care plan for services for the member and ensure the member’s access to those services.
Assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within benefits structure or through extra‑contractual arrangements, as permissible.
Interface with Medical Directors, Physician Advisors and/or Inter‑Disciplinary Teams on the development of care management of person‑centered care plans. May also assist in problem solving with providers, claims or service issues.
Minimum Requirements
Associate of Science in Nursing or Bachelor of Science in Nursing and minimum of 3 years of experience in working with individuals with chronic illnesses, co‑morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or any combination of education and experience, which would provide an equivalent background.
Current, active, valid and unrestricted RN license in Wisconsin is required.
Minimum of one year experience working with at least one of the Family Care target populations is required.
Preferred Skills, Capabilities and Experiences
BA/BS in Health/Nursing preferred.
Strong preference for case management experience with older adults or individuals with disabilities.
Long Term Care background preferred.
Commitment to member‑centered care and cultural responsiveness.
Family Care/Partnership experience preferred.
Comfortable using technology preferred.
Strong interpersonal and communication skills.
Ability to work collaboratively in team environment.
Problem solving and crisis management abilities.
Travels to worksite and other locations including members home/community for in‑person visits.
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.
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.
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