LTSS Service Coordinator - Case Manager (Region I: Miami-Dade/Monroe County)

LTSS Service Coordinator - Case Manager (Region I: Miami‑Dade/Monroe County) Location & Work Hours: Field-based position based in Miami‑Dade or Monroe County. Work schedule: Monday‑Friday, 8:00am–5:00pm EST. Candidates must reside within the specified counties; remote or virtual work is not considered unless accommodated per law. Job Details Field operational focus: travel to client sites for assessments and meetings; occasional office attendance for training. Manage a defined caseload of individuals in specialized LTSS programs. Coordinate interdisciplinary care, including medical directors, interdisciplinary care rounds, and community supports. Implement Person Centered Planning (PCP) process: assessment, Person Centered Support Plan (PCSP), and backup plan. Ensure compliance with state law, contract, and federal requirements for physical, behavioral, and LTSS needs. Document and monitor short‑ and long‑term service goals in collaboration with the member’s chosen care team. Identify members eligible for alternative waiver programs or higher level of service. Responsibilities Conduct face‑to‑face program assessments using predefined tools and motivational interviewing techniques. Identify and address potential clinical health‑care needs, including high‑risk complications and gaps in care. Act as the single point of contact for member cases, coordinating with clinical management and interdisciplinary teams. Manage non‑clinical needs for members with chronic illnesses, co‑morbidities, or disabilities to optimize cost‑effective LTSS utilization. Document and update PCSPs and member goals with care teams, including caregivers, family, natural supports, service providers, and physicians. Submit utilization/authorization requests to utilization management teams. Report critical incidents to state and county agencies (Adult Protective Services, Law Enforcement). Assist with appeals, fair hearings, member grievances, and state audits. Serve as mentor, subject‑matter expert, or preceptor for new staff and contribute to process improvement initiatives. Minimum Requirements BA/BS degree and a minimum of 2 years of experience working with a social work agency, or an equivalent combination of education and experience. Knowledge of state law, contract, and federal requirements for LTSS and behavioral health services. Preferred Skills & Experience BA/BS degree, preferably in a health‑care related field. Bilingual proficiency in English and Spanish (strong preference). Experience in LTSS, case management, social work, or hospital discharge planning. Job Level & Classification Job Level: Non‑Management, Non‑Exempt. Job Family: MED > Medical Ops & Support (Non‑Licensed). Benefits Competitive total rewards: merit increases, paid holidays, paid time off, incentive bonus programs. Health benefits: medical, dental, vision, short‑ and long‑term disability. Retirement: 401(k) with employer match, stock purchase plan. Life insurance and wellness programs. Financial education resources. EEO Statement Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other protected condition per federal, state, and local laws, including the Los Angeles County Fair Chance Ordinance and California Fair Chance Act. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all applicable laws. Prospective employees required to be screened under Florida law should review the resources at HB531 | Florida Agency for Health Care Administration. For assistance with accommodations, contact View email address on click.appcast.io. #J-18808-Ljbffr