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Elevance Health
LTSS Service Coordinator (Case Manager) Western Ohio
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What they do
A Mental or Behavioral Health Case Manager coordinates overall plan of care for patients with mental or behavioral health needs. Oversees patient evaluation and treatment planning and monitors patient progress. Coordinates with the rest of the mental health team, including doctors and nurses, to establish these plans.
$40,735 / year median in Ohio
+16% projected growth
Job Description
- LTSS Service Coordinator (Case Manager)
- Candidates must live in one of the following counties:
- + •Athens•+ •Clermont•+ •Clinton•+ •Defiance•+ •Erie•+ •Fulton•+ •Hamilton•+ •Hancock•+ •Henry•+ •Lucas•+ •Montgomery•+ •Ottawa•+ •Paulding•+ •Pickaway•+ •Ross•+ •Sandusky•+ •Seneca•+ •Warren•+ •Williams•+ •Wood•Location•: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training.
- LTSS Service Coordinator
- is responsible for managing service coordination for a designated caseload in specialized programs.
- How you will make an impact
- : + 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 support. + 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.
Preferred Skills, Capabilities and Experiences:
- + Strong preference for case management experience with older adults or individuals with disabilities.