LTSS Service Coordinator – RN Clinician; RN Case Manager

Overview

LTSS Service Coordinator – RN Clinician (Case Manager). Hiring in the following counties:
Allen, Auglaize, Defiance, Greene, Hardin, Mercer, Van Wert, Williams.

This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.

The MyCare Ohio health plan is to deliver high-quality, trauma-informed, culturally competent, person-centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs.

Please note that per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location will not be considered unless an accommodation is granted as required by law.

The LTSS Service Coordinator-RN Clinician is responsible for overall management of the member s case within the scope of licensure, develops, monitors, evaluates, and revises the member s care plan to meet the member s needs, prioritizing person-centered thinking and optimizing member health care across the care continuum.

• Perform telephonic and face-to-face functional assessments for identification, evaluation, coordination and management of member needs, including physical health, behavioral health, social services and long term services and supports. Identify members for high risk complications and coordinate care 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 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, and physicians; identify members who would benefit from alternative levels of care or other waiver programs.
• Develop the care plan for services for the member and ensure access to those services.
• Assist with 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 Inter-Disciplinary Teams on care management of person-centered care plans; assist in problem solving with providers, claims or service issues.

• Requires a high school diploma or GED and a minimum of 3 years of experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or an equivalent combination of education and experience.
• Current, active RN license in applicable state(s) required.

• BA/BS in Health/Nursing preferred.
• Strong preference for case management experience with older adults or individuals with disabilities.

Note:

Elevance Health reserves the right to manage resumes via agency agreements. Unsolicited resumes may be the property of Elevance Health.

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

We are creating a culture designed to advance our strategy and support personal and professional growth. Our values drive our culture and business outcomes.

We offer market-competitive total rewards including merit increases, paid holidays, paid time off, incentive programs (unless covered by a collective bargaining agreement), medical/dental/vision coverage, disability benefits, 401(k) with company match, life insurance, wellness programs, and financial education resources.

Elevance Health operates a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week. Time onsite requirements will be discussed during the hiring process.

COVID-19 and Influenza vaccination requirements may apply for patient/member-facing roles. If not vaccinated, offers may be rescinded unless an acceptable explanation is provided. Elevance Health will follow all applicable laws.

Elevance Health is an Equal Employment Opportunity employer. All qualified applicants will receive consideration without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status protected by law. Applicants needing accommodation may contact elevancehealthj