- Responsible for performing telephonic 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.
- The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services.
- 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.
- Directs and/or supervises the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, in coordinating services for the member by, for example, assigning appropriate tasks to the non-RN clinicians, verifying and interpreting member information obtained by these individuals conducting additional assessments, as necessary, to develop, monitor, evaluate, and revise the member's care plan to meet the member's needs, and reviewing and providing input on the non-RN clinicians' performance on a regular basis.
- Requires an RN 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, unrestricted RN license in NY required.
- Bilingual - Spanish, Korean, Chinese (Mandarin, Cantonese), Russian, Bengali, Hindi, Urdu preferred
- Bachelor's in Health/Nursing preferred.
- May require state-specified certification based on state law and/or contract.
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
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LTSS Service Coordinator - Brooklyn, United States - Elevance Health
Description
The
LTSS Service Coordinator - RN Telehealth is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops , monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.
How you will make an impact:
Minimum Requirements:
Preferred Skills, Capabilities, and Experiences:
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $80,870 - $105,477.
Location:
New York
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company.
The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws _.
_
