Anthem, Inc. LTSS Service Coordinator in Morristown, Tennessee
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.
This is a field position supporting our LTSS (Long Term Services and Support) members in Greene, Hamblen, and surrounding TN counties. 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 ECF 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.
Required: BA/BS Degree in social work, nursing, education or other human service (e.g. psychology, sociology) or health care profession or other related field as approved by TENNCARE or Have five (5) or more years’ experience as an independent support coordinator or case manager for service recipients in a 1915(c) HCBS Waiver and have completed Personal Outcome Measures Introduction and Assessment Workshop trainings as established by the Council on Quality and leadership.
Strongly Preferred: Master’s degree in a health related field such as social work, professional counseling, or other human service health care profession (e.g. psychology or sociology) preferred; 2 years of experience working with individuals and families with Severe and Persistent Mental Illness (SPMI) and/or significant mental health needs, preferably within the community or an outpatient setting.
Required: Experience working with Individuals with Intellectual and/or Developmental Disabilities.
Strongly Preferred: Experience as a Service Coordinator, Case Management, Advocate or similar role.
Strong computer skills to include Excel and Outlook.
Experience in Long Term care desired.
Approximately 75% travel required within assigned territory.
Waiver experience 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. 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.