Career Center

JOB SUMMARY
The Star+Plus (LTSS) Service Coordinator Level 3 is responsible for overall management of non-HCBS (non-waiver) member's case within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Will perform a mix of face-to-face and telephonic assessments as mandated by state and federal regulations.

JOB SPECIFICATIONS AND CORE COMPETENCIES
Assess, plan, and implement care strategies that are individualized by member and directed toward the most appropriate, lease restrictive level of care.
Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services.
Manage the care plan throughout the continuum of care as a single point of contact.
Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members.
Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team.
Perform telephonic and/or face-to-face clinical 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.
Identify members for high-risk complications and coordinates care in conjunction with the member and the health care team.
Manage members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits.

Provide input and/or data to direct supervisor/manager related to any internal or external mandatory audit or reporting.
Provide input and/or data to direct supervisor/manager related to any internal or external mandatory audit or reporting.
Serve as mentor, subject matter expert or preceptor to new staff.
Involved in process improvement initiatives.
Assist in problem solving with providers, claims or service issues.

Community Health Choice's Core Competencies
Customer Focus
Reliability and Dependability
Honest and Integrity
Change Management
Teamwork
Impact/Influence + Strategic Vision
People/Team Development
Other duties assigned.

QUALIFICATIONS:
Education/Specialized Training/Licensure: High School Diploma or GED required.

LVN preferred.

Work Experience (Years and Area): 2 + years of experience in a health care role working within a community health setting with direct experience working with ABD/SSI client base required.

Experience in long-term care, home health, hospice, public health or assisted living required.

Field based case management experience in a managed care setting, Medicaid Waiver services, or with arranging community resources preferred.

Management Experience (Years and Area): N/A
Software Proficiencies: Microsoft Office

Clinical Documentation Platforms
Other: Local travel required.

Job Family/Job Title Competencies
Problem Analysis
Attention to Detail
Critical Thinking
Thoroughness