Anthem, Inc. LTSS Service Coordinator in Hialeah, Florida
SHIFT: Day Job
Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to 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 at one of America's leading health benefits companies and a Fortune Top 50 Company.
$1,000 Sign On Bonus offered
This is a field position supporting our LTSS (Long Term Services and Support) members in the Orlando area. 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 is responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract; develops, monitors, and revises the member's service plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.
Responsible for performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's long term service and support needs.
Using tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high risk complications) and coordinates those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.
The process does not involve clinical judgment.
Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of long term services and supports.
Establishes short and long term service and support goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of service or other waiver programs.
May also serve as mentor or preceptor for new staff, assisting in the formal training of associates and may be involved in process improvement initiatives.
BA/BS in a health related field preferred; 2 years of experience working with a social work agency; or any combination of education and experience, which would provide an equivalent background
At least 2 years of case management required
Experience with Microsoft Office Suite strongly preferred
CPR Certification strongly preferred
Previous LTSS experience strongly preferred
Experience with PAC, TBI and/or ACS waivers strongly preferred
Bilingual English/Spanish required
Nursing (LPN) background a plus
Experience working the HIV/AIDS and Dementia member population
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity, Inc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.