JOB SUMMARY

The Star+Plus (LTSS) Service Coordinator (SC) Level 2 will work directly with customers, their families and/or advocates to ensure that the member has access to Community Health Choice (CHC) resources offered through the Long-Term Support and Services (LTSS) Program. The SC works collaboratively with the RN case manager to support, promote, and facilitate engagement in the LTSS Case Management Program. The SC will work as a bridge between the customer, the health plan, and the Community based Organizations to create a seamless and positive experience to fulfill their unmet care needs. The SC will build individual capacity by increasing health and wellness self-management skills and sufficiency through a series of activities such as outreach, education, encouragement, social supports, and advocacy.

JOB SPECIFICATIONS AND CORE COMPETENCIES

Essential Functions
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.
Performs telephonic 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.
Identifies members for high-risk complications and coordinates care in conjunction with the member and the health care team

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.

Other duties as assigned


MINIMUM QUALIFICATIONS:

Education/Specialized Training/Licensure: HS Diploma or GED with 4 years relevant experience; OR HS Diploma with qualified IDD certification; OR Bachelor's in social work or a related field; OR LVN, RN, NP PA required.

Undergraduate or graduate degree in social work or a related field; OR be an LVN, LSW, LCSW or LMSW preferred.


Work Experience (Years and Area):
3 years' experience with the ABD/SSI population in three of the last five years

1 year of case management experience in a managed care setting.

1+ years' experience working with Medicaid Waiver services,
Experience with arranging community resources, Field based work experience,
Experience with electronic charting 1 year of case management experience in a managed care setting.

Software Proficiencies: Microsoft Office, Clinical Documentation Platforms
Other: