LTSS Service Coordinator - RN Telehealth (Remote)
About the position
The LTSS Service Coordinator - RN Telehealth is a pivotal role responsible for the comprehensive management of a member's case within the scope of nursing licensure. This position involves providing supervision and direction to non-RN clinicians who are part of the member's care team, ensuring that all actions comply with applicable state laws and contractual obligations. The primary goal is to develop, monitor, evaluate, and revise care plans tailored to meet the unique needs of each member, thereby optimizing their healthcare experience across the continuum of care. In this role, the RN will conduct telephonic clinical assessments to identify, evaluate, coordinate, and manage the various needs of members, which encompass physical health, behavioral health, social services, and long-term services and supports. The RN will also identify members at high risk for complications and coordinate care in collaboration with the member and the healthcare team. Managing members with chronic illnesses, co-morbidities, and disabilities is essential to ensure the effective and efficient utilization of health benefits. The RN is responsible for obtaining thorough and accurate member histories to develop individualized care plans. This includes establishing both short-term and long-term goals in partnership with the member, their caregivers, family, and healthcare providers. The RN will also identify members who may benefit from alternative levels of care or other waiver programs. Additionally, the RN will facilitate authorizations and referrals for services as needed, ensuring that members have access to the necessary resources. Collaboration with Medical Directors, Physician Advisors, and Inter-Disciplinary Teams is crucial for developing effective care management treatment plans. The RN will also supervise the work of LPNs, LSWs, LCSWs, LMSWs, and other licensed professionals, ensuring that tasks are appropriately assigned and that the care plan is continuously monitored and adjusted as necessary. Regular performance reviews and feedback for non-RN clinicians will also be part of the RN's responsibilities.
Responsibilities
Perform telephonic clinical assessments to identify, evaluate, coordinate, and manage member needs.
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Identify members at high risk for complications and coordinate care with the healthcare team.
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Manage members with chronic illnesses, co-morbidities, and disabilities to ensure efficient utilization of health benefits.
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Obtain thorough and accurate member histories to develop individual care plans.
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Establish short and long-term goals in collaboration with members, caregivers, and healthcare providers.
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Develop care plans for services and ensure members have access to those services.
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Facilitate authorizations and referrals for service utilization within benefits structure.
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Interface with Medical Directors and Inter-Disciplinary Teams on care management treatment plans.
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Supervise and direct the work of non-RN clinicians in coordinating services for members.
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Review and provide input on the performance of non-RN clinicians regularly.
Requirements
Current, unrestricted RN license in NY required.
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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.
Nice-to-haves
Bachelor's degree in Health/Nursing preferred.
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State-specified certification based on state law and/or contract may be required.
Benefits
Comprehensive benefits package
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Incentive and recognition programs
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Equity stock purchase
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401k contribution
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Paid holidays
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Paid Time Off
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Medical, dental, and vision benefits
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Short and long-term disability benefits
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Life insurance
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Wellness programs
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Financial education resources
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