Overview RN Case Manager (LTSS Service Coordinator- RN Clinician) Location: Seeking candidates to reside in Madison, Delaware, Henry, Wayne, Randolph, Jay, Blackford, Grant, Rush, Fayette, or Union County Indiana. This is a field-based role with occasional office attendance for meetings or training. Hybrid/virtual work policy applies as noted below.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting locations will not be considered for employment, unless an accommodation is granted as required by law.
Field: 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.
Responsibilities Responsible for performing 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.
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 ensure 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 non-RN clinicians (e.g., LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals) in coordinating services for the member, including task assignment, verification of member information, additional assessments as necessary, and evaluating the non-RN clinicians' performance.
Minimum Requirements Requires an RN and 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 any combination of education and experience that would provide an equivalent background.
Current, unrestricted RN license in applicable state(s) required.
Preferred Skills, Capabilities And Experiences MA/MS in Health/Nursing preferred.
Experience working with older adults in care management, provider or other capacity, highly preferred.
Experience managing a community and/or facility-based care management caseload, highly preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
About Elevance Health Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy and support personal and professional growth for our associates. Our values and behaviors are the root of our culture. They guide our strategy, power business outcomes and drive our shared success for our consumers, our associates, our communities and our business.
We offer market-competitive total rewards, including merit increases, paid holidays, Paid Time Off, incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs and financial education resources.
Elevance Health operates in 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, and potentially several times per week. Specific onsite expectations will be discussed during the hiring process.
The health of our associates and communities is a top priority. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer may be rescinded unless you provide an acceptable explanation. Elevance Health will follow all relevant federal, state and local laws.
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 protected by applicable laws. Applicants requiring accommodation may contact elevancehealthjobssupport@elevancehealth.com for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
Seniorities & Employment Type Mid-Senior level
Full-time
Job Function & Industries Job function: Health Care Provider
Industries: Hospitals and Health Care