LTSS Service Coordinator
Company: Elevance Health
Posted on: November 18, 2023
LTSS Service Coordinator Location: This is primarily a field
based position. Candidate would work from home and meet face to
face with patients and providers. This position requires travel to
worksite and other locations as necessary. The LTSS Service
Coordinator is responsible for conducting service coordination
functions for a defined caseload of individuals in specialized
programs. In collaboration with the person supported, facilitates
the Person Centered Planning process that documents the member's
preferences, needs and self-identified goals, including but not
- Conducting assessments, development of a comprehensive Person
Centered Support Plan (PCSP) and backup plan.
- Interfacing with Medical Directors and participating in
interdisciplinary care rounds to support development of a fully
integrated care plan.
- Engaging the member's circle of support and overall management
of the individuals physical health (PH)/behavioral health (BH)/LTSS
needs, as required by applicable state law and contract, and
federal requirements. Primary duties may include but are not
- Responsible for performing face to face program assessments
(using various tools with pre-defined questions) for
identification, applying motivational interviewing techniques for
evaluations, coordination, and management of an individual's waiver
(such as LTSS/IDD), and BH or PH needs.
- Uses tools and pre-defined identification process, identifies
members with potential clinical health care needs (including, but
not limited to, potential for high-risk complications, addresses
gaps in care) and coordinates those member's cases (serving as the
single point of contact) with the clinical healthcare management
and interdisciplinary team in order to provide care coordination
- Manages non-clinical needs of members with chronic illnesses,
co-morbidities, and/or disabilities, to ensure cost effective and
efficient utilization of long-term services and supports.
- At the direction of the member, documents their short and
long-term service and support goals in collaboration with the
member's chosen care team that may include, caregivers, family,
natural supports, service providers, and physicians.
- Identifies members that would benefit from an alternative level
of service or other waiver programs.
- May also serve as mentor, subject matter expert or preceptor
for new staff, assisting in the formal training of associates, and
may be involved in process improvement initiatives.
- Submits utilization/authorization requests to utilization
management with documentation supporting and aligning with the
individual's care plan.
- Responsible for reporting critical incidents to appropriate
internal and external parties such as state and county agencies
(Adult Protective Services, Law Enforcement).
- Assists and participates in appeal or fair hearings, member
grievances, appeals, and state audits. Minimum Requirements:
- Requires BA/BS degree and a minimum of 2 years of experience
working with a social work agency; or any combination of education
and experience which would provide an equivalent background.
- Specific education, years, and type of experience may be
required based upon state law and contract requirements. Preferred
- BA/BS degree field of study in health care related field
- Bilingual in English/ Spanish preferred.
Keywords: Elevance Health, Miami , LTSS Service Coordinator, Other , Miami, Florida
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