Ltss Eligibility Coordinator
CurrentResponsible for overall management of member's individual service plan, develops, monitors, and revises the member's service plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.Responsible for performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's long-term service and support needs.Using tools and… Show more Responsible for overall management of member's individual service plan, develops, monitors, and revises the member's service plan to meet the member's needs, with the goal of optimizing member health care across the care continuum.Responsible for performing telephonic or face-to-face history and program needs assessments using a tool with pre-defined questions for the identification, evaluation, coordination and management of member's long-term service and support needs.Using tools and pre-defined identification process, identifies members with potential clinical health care needs (including, but not limited to, potential for high-risk complications) and coordinates those member's cases with the clinical healthcare management and interdisciplinary team in order to provide care coordination support.The process does not involve clinical judgment. 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.Establishes short term and long-term service and support goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of service or other waiver programs.May also serve as mentor or preceptor for new staff, assisting in the formal training of associates and may be involved in process improvement initiatives. Show less