LTSS Service Coordinator - RN

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

LOCATION: This is a field designated role for the areas of Erie and Niagara Counties. New York residency is required. When you are not traveling, you will work virtually from your home. HOURS: Standard business hours, Monday through Friday. TRAVEL: Travel is required within the above areas visiting members in their homes or in a care facility. 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. The LTSS Svc Coordinator RN-Clinician is responsible for overall management of member's case within the scope of licensure. The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services.

Responsible for performing telephonic or face-to-face clinical assessments for the identification, evaluation, coordination, and management of member's needs, including physical health, behavioral health, social services, and long term services and supports. Identifies members for high-risk complications and coordinates care in conjunction with the member and the health care team. Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. Obtains a thorough and accurate member history to develop an individual care plan. Establishes short- and long-term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs. May 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. Interfaces with Medical Directors, Physician Advisors, and/or Inter-Disciplinary Teams on the development of care management treatment plans. May also assist in problem solving with providers, claims or service issues. May direct or supervise the work of any LPN, LCSW, LMSW, or other licensed professionals than an RN, in coordinating services for the member. Travels to worksite and other locations as necessary.