LTSS Transition Coordinator

Company Information: A healthcare company with corporate office located in Indianapolis Metro area, serving more than 100 million people at every stage of health.

Location: This position is primarily remote. Candidates must have an appropriate home workspace and be available for occasional in-person team meetings.

Job Summary: The LTSS Transition Coordinator supports the LTSS Coordinator (or contracted provider) in executing the person-centered planning process during transitions of care for individuals moving between various levels of care.

Job Duties:

· Coordinate and manage transitions for individuals moving between different care settings. Including home care, assisted living and skilled nursing facilities.

· Collaborate with healthcare providers, social workers, and other stakeholders to ensure a seamless transition process.

· Responsible for ensuring the effectiveness of the care plan and complying with contractual requirements for member outreach, including coordination and management of individual waivers (such as LTSS/IDD), behavioral health or physical health needs.

· Submit utilization/authorization request to utilization management ensuring documents supports and aligns with the individual’s care plan.

· Utilize tools and a pre-defined identification process to consult with the primary service coordinator, monitoring personalized care and support plan (PCSP) when a risk is identified concerning the member’s LTSS, etc.

· Oversees the non-clinical requirements of members with chronic illnesses, co-morbidities, and/or disabilities, aiming for cost-effective and streamlined utilization of long-term services and supports.

· Collaborate with the member’s chose care team, which may consist of caregivers, family, natural supports, and physicians to document their short- and long-term service and support objectives, as directed by the member.

· Identifies members who may benefit from alternative service levels or other waiver programs.

· May serve as subject matter expert, mentor, or preceptor for new staff, contributing to formal training programs for associates and potentially engaging in process enhancement endeavors.

· Accountable for promptly reporting critical incidents to pertinent internal and external entities, including state and county agencies such as Adult Protective Services and Law Enforcement.

· Provide support and actively participate in appear or fair hearings, member grievances, appeals and state audits.

Job Qualifications:

· Requires a BA/BS with a minimum of two years working with social work agency, LTSS, healthcare, and/or aged and disability industry experience; or any combination of education and experience which would provide an equivalent background.

· Experience managing a community and/or facility-based care management case load, highly preferred.

· Experience working from home is a plus.

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