LTSS Service Coordinator - RN

Location: The location for this position includes Knox, Anderson, Claiborne, Williamson, Davidson, Montgomery, Shelby, Tipton, Fayette, Sumner, Trousdale, Smith, Macon, Hamilton, Sequatchie, Marion, or Robertson Counties in Tennessee.

Field
:
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.

LTSS Service Coordinator‑RN 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.

• Perform 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.
• 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 to ensure 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.
• The RN has overall responsibility to develop the care plan for services for the member and ensures 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 treatment plans.
• Assist in problem solving with providers, claims or service issues.
• Direct and/or supervise the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, 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 for the member's needs, and reviewing and providing input on the non‑RN clinicians' performance on a regular basis.

• Requires an RN; 3‑4 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 applicable state(s) required.

• Travels to worksite and other locations as necessary.

Equal Employment Opportunity – 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, and local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj 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.