STAR+PLUS LTSS Srvc Coor Levl3

Internal Number: 172929

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.
* Assists in meeting member needs by referring members to internal and external resources.
* Provide follow up with internal and external resources, providers, and state programs.
Marginal Functions
* 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
* Other duties as assigned.

MINIMUM 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.
* Experience in long-term care, home health, hospice, public health, or assisted living.
* Field based case management experience in a managed care setting, Medicaid Waiver services, or with arranging community resources.
Management Experience (Years and Area): N/A
Software Proficiencies:
* Microsoft Office
* Clinical Documentation Platforms
Other:
* Local travel required.
* Reliable transportation with valid driver’s license with good driving record.