LTSS Coordinator - Nevada

Job Title: LTSS Coordinator - Nevada


Location: Nevada



Type: Contract


Compensation: $33/Hour


Contractor Work Model: Remote


 

Title:  LTSS Coordinator - Nevada

ALTA is supporting a 5-month contract opportunity working 100% remote.
Candidates can reside anywhere in the US as long as they have a current license for the state of Nevada.

ALTA IT Services is a wholly owned subsidiary of System One, a leading provider of specialized workforce solutions and integrated services. ALTA is an established leader in IT Staffing and Services, for both government and commercial enterprises across the United States, specializing in Program & Project Management, Application Development, Cybersecurity, Data & Advanced Analytics, and Agile Transformation Services.

The LTSS Coordinator - Nevada monitors and promotes effective utilization of long-term services and supports through clinical review and benefits management.

Essential Functions:

• Serve as point of contact with the Primary Care Manager, Medical Director, Provider, or other internal/external stakeholders.
• Collaborate as part of the interdisciplinary care team (ICT) to coordinate personal care/self-directed services that assist members with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) helping them maintain independence in their homes.
• Coordinate, oversee, and provide insights into the clinical documentation system for
  
  processing approvals and denials, notify care management team of LTSS approvals and denials, and support the appeals process as needed
• Collaborate with Care Managers and/or providers to collect clinical documentation required for LTSS reviews of personal care/self-directed services.
• Within the electronic health record and verification visit systems: verify eligibility, review existing documents to include, but not limited to, assessments, treatment plans, case notes, referrals, and care team members, ensuring compliance with accreditation and compliance guidelines
• Ensure accurate completion and upload of functional assessments into electronic medical record, leading to the creation of person-centered service plans and prior authorizations based on assessment findings
• Assist in developing and implementing updated care treatment plans by identifying specific issues, prioritizing goals and defining interventions related to personal care/self-directed services with agreement from all parties involved
• Collaborate with Care Managers, Medical Directors, Discharge Planners, Providers and/or other stakeholders as needed to ensure personal care/self-directed services are in place to support safe discharge plans between levels of care when clinically appropriate
• Work closely with case management to address any changes in member’s assessed level of care or determinations made by providers or external stakeholders
• Maintain knowledge of federal and state regulations governing CareSource, state contracts, provider agreements, and Nevada Medicaid Personal Care Services Program benefits.
• Attend interdisciplinary team meetings, state hearings, and medical advisement meetings as requested
• Identify care coordination needs to the appropriate case management team and leaders
• Recognize and refer quality issues to Quality Improvement team
• Provide guidance and mentorship new staff
• Maintain required reporting and assists with data analysis as needed
• Performs any other job related duties as requested.
  

Education and Experience:

• Associates of Science (A.S) degree in Nursing or degree required to obtain Social Worker licensure in the state of Nevada required
• Bachelor's Degree in Nursing (BSN) or equivalent baccalaureate degree in healthcare-related field preferred
• Three (3) years of experience in case management and/or managed care required
• Experience in a Medicare and/or Medicaid managed care environment preferred
  
  Post-acute, home care, waiver, or acute clinical care experience preferred
  

Competencies, Knowledge and Skills:

• Intermediate proficiency in Microsoft Office Suite
• Basic level knowledge of a Windows-based environment
• Excellent written and verbal communication skills
• Ability to work with diverse populations in a non-judgmental manner
• Ability to work independently and within a team
• Strong organizational skills
• Excellent assessment skills and attention to detail
• Knowledge of Medicare and Medicaid
• Strong critical thinking and listening skills
• Effective time management skills
• Customer service oriented
• Decision-making and problem-solving skills
• Familiarity of evidence-based medical criteria and standards of care
  

Licensure and Certification:

• Current, unrestricted Registered Nurse (RN), Licensed Social Worker (LSW), or Licensed Independent Social Worker (LISW) licensure in the state of Nevada required
• Case Management Certification (CCM) preferred

  

System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.



System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.



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Ref: #860-IT Cincinnati