Family Care-Registered Nurse

LTSS Service Coordinator - RN Clinician (RN Case Manager)

Hiring near Southwestern Wisconsin in counties:
Pepin, Buffalo, Trempealeau, Jackson, Clark, La Crosse, Monroe, Juneau, Vernon, Sauk, Richland, Crawford, Grant, Iowa, Lafayette, Green.

Field:
This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as required, with occasional office attendance for meetings or training.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Anthem is very excited to be a managed care organization in western/southwestern Wisconsin and Milwaukee County to offer the Family Care Program. Family Care is a Wisconsin long‑term care program for older adults and adults with disabilities.

Objective:
The LTSS Service Coordinator‑RN Clinician is responsible for overall management of member’s case within the scope of licensure, developing, monitoring, evaluating, and revising the member’s care plan to meet the member’s needs with a person‑centered focus.

• Perform telephonic and face‑to‑face functional 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 high‑risk members and coordinate care with the member and the health care team.
• Manage members with chronic illnesses, co‑morbidities, and/or disabilities, ensuring cost‑effective and efficient utilization of health benefits.
• Obtain a thorough and accurate member history to develop an individual care plan.
• Establish short and long‑term goals in collaboration with the member, caregivers, family, natural supports, physicians; identify members who would benefit from an alternative level of care or other waiver programs.
• Develop the care plan for services for the member and ensure the member’s access to those services.
• Assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate, within the benefits structure or through extra‑contractual arrangements, as permissible.
• Interface with Medical Directors, Physician Advisors and/or Inter‑Disciplinary Teams on the development of person‑centered care plans. Assist in problem‑solving with providers, claims or service issues.

• Associate of Science in Nursing or Bachelor of Science in Nursing and a minimum of 3 years of experience in working with individuals with chronic illnesses, co‑morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role; or an equivalent combination of education and experience.
• Current, active, valid and unrestricted RN license in Wisconsin.
• Minimum of one year experience working with at least one of the Family Care target populations.

• BA/BS in Health or Nursing preferred.
• Case management experience with older adults or individuals with disabilities.
• Long‑Term Care background preferred.
• Commitment to member‑centered care and cultural responsiveness.
• Family Care/Partnership experience preferred.
• Comfortable using technology.
• Strong interpersonal and communication skills.
• Ability to work collaboratively in a team environment.
• Problem‑solving and crisis management abilities.
• Travels to worksite and other locations, including members’ homes and communities, for in‑person visits.

Elevance Health is an Equal Employment Opportunity employer. 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 us for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 Florida Agency for Health Care Administration.

All new candidates in patient/member‑facing roles are required to be vaccinated against COVID‑19 and Influenza. If not vaccinated, an offer may be rescinded unless an acceptable explanation is provided.

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