AddressDescription
Managed Care Coordinator
Location: Candidate must reside in Virginia, preferably in or around Richmond or Roanoke, VA. While primarily remote, occasional visits to facilities or meeting members face to face in their homes may be required.
The Managed Care Coordinator , as required by applicable state law and contract, contributes to the care coordination process by performing activities within the scope of licensure including 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 community services and supports. Position primarily serves individuals with intellectual and/or developmental disabilities.
Primary duties may include, but are not limited to:
Assists in identifying members for high risk complications. Obtains clinical data as directed.
Assists in identifying members that would benefit from an alternative level of care or other waiver programs.
Conducts clinical 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, 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.
Minimum Requirements:
Requires an LPN/LVN, LSW, LCSW, or LMSW or license other than RN in accordance with applicable state law and Nursing Diploma or AS in Nursing or a related field and minimum of 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/LVN, LSW, LCSW, LMSW or license other than RN (as allowed by state law) in Virginia required.
Position is primarily telephonic/telehealth but very limited travel or in person work may be required.
Preferred Qualifications:
Experience with Developmental Disabilities and/or Behavioral Health strongly preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
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.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.
