LTSS Nursing Facility Service Coordiantor Level 1

Job Number: 179330, Job Title: LTSS Nursing Facility Service Coordinator Level 1*, Salary: $67,200.00 - $85,000.00

JOB SUMMARY

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 any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals other than an RN, by assigning appropriate tasks, verifying and interpreting member information, conducting additional assessments as necessary, monitoring, evaluating, and revising care plans. Assists in meeting member needs by referring members to internal and external resources. Provides follow up with internal and external resources, providers, and state programs. Coordinates with and participates in ICT meetings with Nursing Facility Staff, member, Responsible Party, treating physicians, therapists, and any other applicable parties. Coordinates and assists with the transition to the community through the Money Follows the Person (MFP) process for members who indicate a desire to leave the nursing facility.

MARGINAL FUNCTIONS

Provide input and/or data to direct supervisor/manager related to any internal or external mandatory audit or reporting. Serve as mentor, subject matter expert or preceptor to new staff. Involved in process improvement initiatives. Assist in problem solving with providers, claims or service issues. Other duties as assigned.

CORE COMPETENCIES

Customer Focus Reliability and Dependability Honesty and Integrity Change Management Teamwork Impact/Influence + Strategic Vision People/Team Development

MINIMUM QUALIFICATIONS

Current unrestricted RN license in Texas, graduate of an accredited school of nursing. Bachelor’s degree in nursing preferred. CCM (Emergency Care or comparable certification) required. 3-4 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or equivalent combination of education and experience. 1 year experience working with population who receive waiver services. 1 year experience working with persons with disabilities/chronic conditions and Long-Term Services & Supports. Software proficiencies: Microsoft Office, clinical documentation platforms, Internet. Local travel required; reliable transportation with valid driver's license and good driving record. #J-18808-Ljbffr Direct Jobs