Anthem, Inc. LTSS Service Coordinator-Clinician in McKenzie, Tennessee
SHIFT: Day Job
Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s the foundation upon which we’re creating greater care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve.
This is a field position supporting our LTSS (Long Term Services and Support) members in Gibson, Carroll, Henry, Weakley and surrounding TN County areas. When not in the field, you will be working from home (mileage reimbursed). You must have the flexibility to come into an Anthem office for meetings if needed. Related computer equipment for a home office will be provided. You must have a high speed data connection.
The LTSS Service Coordinator-Clinician works under the direction/supervision of an RN, with overall responsibility for the member's case, as required by applicable state law and contract, contributes to the LTSS care coordination process by performing activities within the scope of licensure including, for example, assisting the responsible RN with telephonic or face-to-face 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.
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.
Decision making skills will be based upon the current needs of the member and require an understanding of disease processes and terminology and the application of clinical guidelines but do not require nursing judgment of health benefits. Decision making skills will be based upon the current needs of the member and require an understanding of disease processes and terminology and the application of clinical guidelines but do not require nursing judgment.
LPN, LBSW, LCSW, or LMSW or license other than RN in accordance with applicable state law; Nursing Diploma or AS in Nursing or a related field; 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, LCSW, LMSW or license other than RN (as allowed by state law) in Tennessee required.
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.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.