LTSS Transition Coordinator

Job Description
Company Information : A healthcare company with corporate office located in Indianapolis Metro area, serving more than 100 million people at every stage of health.

Location: This position is primarily remote. Candidates must have an appropriate home workspace and be available for occasional in-person team meetings.

Job Summary : The LTSS Transition Coordinator supports the LTSS Coordinator (or contracted provider) in executing the person-centered planning process during transitions of care for individuals moving between various levels of care.

Job Duties:
•Coordinate and manage transitions for individuals moving between different care settings. Including home care, assisted living and skilled nursing facilities.
•Collaborate with healthcare providers, social workers, and other stakeholders to ensure a seamless transition process.
•Responsible for ensuring the effectiveness of the care plan and complying with contractual requirements for member outreach, including coordination and management of individual waivers (such as LTSS/IDD), behavioral health or physical health needs.
•Submit utilization/authorization request to utilization management ensuring documents supports and aligns with the individual's care plan.
•Utilize tools and a pre-defined identification process to consult with the primary service coordinator, monitoring personalized care and support plan (PCSP) when a risk is identified concerning the member's LTSS, etc.
•Oversees the non-clinical requirements of members with chronic illnesses, co-morbidities, and/or disabilities, aiming for cost-effective and streamlined utilization of long-term services and supports.
•Collaborate with the member's chose care team, which may consist of caregivers, family, natural supports, and physicians to document their short- and long-term service and support objectives, as directed by the member.
•Identifies members who may benefit from alternative service levels or other waiver programs.
•May serve as subject matter expert, mentor, or preceptor for new staff, contributing to formal training programs for associates and potentially engaging in process enhancement endeavors.
•Accountable for promptly reporting critical incidents to pertinent internal and external entities, including state and county agencies such as Adult Protective Services and Law Enforcement.
•Provide support and actively participate in appear or fair hearings, member grievances, appeals and state audits.

Job Qualifications:
•Requires a BA/BS with a minimum of two years working with social work agency, LTSS, healthcare, and/or aged and disability industry experience; or any combination of education and experience which would provide an equivalent background.
•Experience managing a community and/or facility-based care management case load, highly preferred.
•Experience working from home is a plus.
•Note: Hours TBD; Starting Salary $45, 000 to $60,000 (based on experience) Health Insurance and Benefits offered.