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Elevance Health

Sells health insurance and pharmacy benefits

LTSS Service Coordinator Clinician

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-time

About the Job

Requirements

  • Requires an LPN/LVN, LSW, LCSW, LMSW, or license other than RN in accordance with applicable state law, and a Nursing Diploma or Associate of Science in Nursing or a related field, with a minimum of 2 years of experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator or similar role; an equivalent combination of education and experience may also qualify.
  • A current, unrestricted LPN/LVN, LSW, LCSW, LMSW, or other license apart from RN, as allowed by state law, is required in applicable states.

Responsibilities

  • The clinician is responsible for the member's case and contributes to the LTSS care coordination process by performing activities within the scope of licensure, including telephonic or face-to-face assessments to identify, evaluate, coordinate, and manage member needs across physical health, behavioral health, social services, and long-term services and supports.
  • Assist in identifying members at risk of complications and obtain clinical data.
  • Assist in identifying members who could benefit from an alternative level of care or other waiver programs.
  • Provide collected information to the RN, who verifies and interprets it, conducts additional assessments as necessary, and develops, monitors, evaluates, and revises the member's care plan.
  • Participate in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed by the responsible RN, working with the RN, member, and health care team to support cost-effective and efficient utilization of health benefits.
  • Make decisions based on current member needs and apply understanding of disease processes, terminology, and clinical guidelines without exercising nursing judgment.

Desired Qualifications

  • Case management experience with older adults or individuals with disabilities is strongly preferred.
  • A bachelor's degree in Health or Nursing is preferred.

About the Company

Elevance Health

Sells health insurance and pharmacy benefits

Elevance Health is one of the largest U.S. health insurers, covering people through employers, individual plans, Medicare and Medicaid. It is the Blue Cross Blue Shield licensee in 14 states, where it sells plans under the Anthem name, and it runs government plans under the Wellpoint name in other markets. Its Carelon division runs the CarelonRx pharmacy benefit manager and sells behavioral health, care management and other services to its own plans and outside clients. Elevance earns most of its revenue from premiums paid by employers, members and government programs, plus fees for Carelon services. The company is headquartered in Indianapolis, Indiana.

Company size
10,001+
Company stage
IPO
Headquarters
Indianapolis, IN
Founded
1944

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