LTSS Concierge Coordinator
Location: Anywhere in New Jersey
The LTSS Concierge Coordinator develops, monitors, and revises Service Coordination forms and tools, such as the individual’s Person-Centered Support Plan (PCSP) in accordance with member’s needs and contributes to the components of the person-centered planning process to support individuals in meeting their established goals, in the setting of their choice, and accessing quality health care services and supports.
Primary duties may include but are not limited to:
Responsible for performing telephonic and/or outreach to individuals in specialized programs, providers, or other key stakeholders to support the efficacy of the care plan and/or to align with contractual requirements for member outreach, such as coordination and management of an individual’s waiver (such as LTSS/IDD), behavioral health or physical health needs.
Submits utilization/authorization requests to utilization management with documentation supporting and aligning with the individual’s care plan.
Using tools and pre-defined identification process, consults with the primary service coordinator to monitor the PCSP, in instances in which a risk is identified related to the members LTSS, physical or behavioral health supports (including, but not limited to, potential for high-risk complications).
Engages the primary service coordinator and other clinical healthcare management and interdisciplinary teams to provide care coordination support.
Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost effective and efficient utilization of long-term services and supports.
At the direction of the member, documents their short- and long-term service and support goals in collaboration with the member’s chosen care team that may include, caregivers, family, natural supports, and physicians. Identifies members that would benefit from an alternative level of service or other waiver programs.
May also serve as mentor, subject matter expert or preceptor for new staff, assisting in formal training of associates and may be involved in process improvement initiatives.
Responsible for reporting critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
Assists and participates in appeal or fair hearings, member grievances, appeals and state audits.
Requires BA/BS degree and a minimum of 2 years of experience working with a social work agency; or any combination of education and experience which would provide an equivalent background.
Specific education, years, and type of experience may be required based upon state law and contract requirements.
Preferred Skills, Capabilities and Experiences:
BA/BS degree field of study in health care related field preferred.
Experience using Microsoft Office Suite including Outlook, Word and Excel preferred
Experience working with nursing facilities preferred
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $51,787/year to $77,692/year
Locations: California; Colorado; Nevada; Washington State; Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. 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 email@example.com for assistance.