Managed Care Coordinator-Clinician NonRN at Elevance Health in Roanoke, Virginia

Managed Care Coordinator-Clinician NonRN

Location: Roanoke, VA. The ideal candidate will reside in Charlottesville, Lexington, or Staunton, VA. Other locations include Norfolk, VA; Chesapeake, VA; or Richmond, VA. Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

The Managed Care Coordinator-Clinician NonRN will be working under the direction/supervision of an RN, with overall responsibility for the member's case, as required by applicable state law and contract, and will contribute to the care coordination process by performing activities within the scope of licensure. The role assists the responsible RN with telephonic or face-to-face assessments for the identification, evaluation, coordination and management of the member's needs, including physical health, behavioral health, social services, and community services and supports.

How you will make an impact:

• Assists responsible RN in identifying members for high risk complications.
• Obtains clinical data as directed by the responsible RN.
• Assists the responsible RN in identifying members that would benefit from an alternative level of care or other waiver programs.
• Provides all information collected to the responsible RN, who verifies and interprets the information, conducts additional assessments, as necessary, and develops, monitors, evaluates, and revises the member's care plan to meet the member's needs.
• Participates in coordinating care for members with chronic illnesses, co-morbidities, and/or disabilities as directed by responsible RN, and in conjunction with the RN, member and the health care team, to ensure cost effective and efficient utilization of health benefits.
• Applies clinical guidelines and decision making skills based upon the current needs of the member, requiring an understanding of disease processes and terminology, but not requiring nursing judgment.

Minimum Requirements:

• Requires an LPN/LVN, LSW, LCSW, or LMSW or license other than RN in accordance with applicable state law and Nursing Diploma or AS in Nursing or a related field and minimum of 2 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator or similar role; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted LPN/LVN, LSW, LCSW, LMSW or license other than RN (as allowed by state law) in applicable state(s) required.

Preferred Skills, Capabilities and Experiences:

• MA/MS in Health/Nursing preferred.
• LPC is also an acceptable licensure.
• May require state-specified certification based on state law and/or contract.
• Travels to worksite and other locations as necessary.

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. 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 status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact View email address on click.appcast.io for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.