LTSS Service Coordinator Lead
Elevance Health

LTSS Service Coordinator Lead

Location: This is a field based position. Candidate will work remotely from home and travel around their assigned territory.

The LTSS Service Coordinator Lead is responsible for assisting management with day to day activities, such as monitoring and prioritizing workflow.

How you will make an impact:

• Performs reviews to ensure forms are completed accurately and timely.
  
• Assists in the development and maintenance of policies and procedures, training materials and job resources.
  
• Leads projects and participates in workgroups with cross-functional teams and serves as a representative on business unit and enterprise initiatives.
  
• Performs process evaluations and tests and monitors systems/process enhancements.
  
• Responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract; develops, monitors, and revises the member's service plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.
  
• Responsible for performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's long term service and support needs.
  
• Using tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high risk complications) and coordinates those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support. The process does not involve clinical judgment.
  
• Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of long term services and supports.
  
• Establishes short and long term service and support goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of service or other waiver programs.
  
• May also serve as mentor or preceptor for new staff, assisting in the formal training of associates and may be involved in process improvement initiatives.
  

• BA/BS degree required and a minimum of 2 years of experience working with a social work agency as well as a minimum of 5 years of experience in working with individuals with chronic illnesses, co-morbidities and/or disabilities in a Service Coordinator or similar role; or any combination of education and experience which would provide an equivalent background.
  
• Specific education and years and type of experience may be required based upon state law and contract requirements.
  

• Bilingual in English/ Spanish strongly preferred.
  
• BA/BS degree field of study in health care related field preferred.
  
• Travels to worksite and other locations as necessary.