Hybrid LTSS Service Coordinator – Case Manager

at Elevance Health

• Job title: LTSS Service Coordinator – Case Manager
• Job type: Full Time
• Experience level: Junior, Mid level
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Gary, United States

About the role

• LTSS Service Coordinator managing service coordination functions for individuals in the IN PathWays for Aging program. Collaborating with healthcare teams for integrated care plans and support structure.

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 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 including 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

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
• Experience working with older adults in care management, provider or other capacity, highly preferred
• Experience managing a community and/or facility-based care management case load, highly preferred
• BA/BS degree field of study in health care related field preferred
• Travels to worksite and other locations as necessary.

Benefits

• merit increases
• paid holidays
• Paid Time Off
• incentive bonus programs
• medical
• dental
• vision
• short and long term disability benefits
• 401(k) +match
• stock purchase plan
• life insurance
• wellness programs
• financial education resources