Anthem, Inc. LTSS Service Coordinator / Reportable Events Manager in San Diego, California
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 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.
$1,000 Sign On Bonus Offered
This is a field position and can be based ANYWHERE IN THE US.
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.
The Reportable Events Manager will be responsible quality improvement efforts surrounding receiving, tracking, and trending reportable events for the ECF CHOICES and CHOICES populations while also managing the quality monitoring survey process for our provider network through collaborative engagement with internal and external stakeholders
The health and safety of our associates, members and communities is a top priority for Anthem. This priority has become increasingly important as we continue to face the challenges of the COVID-19 pandemic. Anthem believes vaccination is the best way to reduce the spread of COVID-19 and protect our members, our communities, our families and ourselves. To minimize the risk of transmission of the COVID-19 virus and maintain a safe and healthy workplace, vaccination is required for this role. (At Anthem, fully vaccinated means it has been at least two weeks since you have received the second dose of a two-dose vaccine such as Moderna or Pfizer, or the single dose of a single dose vaccine, such as Johnson & Johnson).
If you do not meet the requirements for this position, we encourage you to review other positions that currently allow virtual work. If you have a medical or sincerely held religious reason for not being vaccinated, consistent with applicable law, Anthem will consider requests for reasonable accommodation on this basis. Should you have any questions regarding the requirement after applying, email TalentAcquisition_VaccinationSupport@anthem.com
At least 2 years of case management experience required
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
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 strongly preferred
Experience working the HIV/AIDS and Dementia member population preferred
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. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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.