LTSS Service Coordinator - Auditor
Elevance Health

LTSS Service Coordinator - Auditor

Location: Candidates must be located in the state of Indiana

The LTSS Service Coordinator-Auditor is responsible for auditing member individual service plans within the scope of position, as required by applicable state law and contract. The scope of the audit process includes the review of non-clinical aspects that are functional in nature. The role does not involve clinical judgment.

How you will make an impact:

• Audits program needs assessments and member's long term service and support needs to ensure that established service plans are appropriate.
  
• Audits to determine whether members with potential clinical health care needs (including, but not limited to, potential for high risk complications) are coordinated with the clinical healthcare management and interdisciplinary team.
  
• Audits to determine whether the non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, are being met to insure cost effective and efficient utilization of long term services and supports.
  
• Audits the short and long term service and support goals that were established for the member and ensures the level of service and/or waiver programs are appropriate.
  
• Documents audit findings, identifies issues and informs management.
  
• Assesses and identifies training opportunities for the staff.
  

• Requires BA/BS degree and a minimum of 2 years experience working with a social work agency ton include a minimum of 2 years LTSS service coordinator experience; or any combination of education and experience which would provide an equivalent background.
  
• Specific education and years and type of experience may be required based upon state law and contract requirements.
  
• Travels to worksite and other locations as necessary.
  

• BA/BS degree field of study in health care related field preferred.