Care Coordinator

This is a fully remote position, open to applicants in New Mexico.

📋 Description

• Coordinate care for individual clients through assessment, care planning, implementation, coordination, monitoring, and evaluation.

• Execute duties either virtually or in-person in accordance with contractual obligations.

• Encourage the judicious use of clinical and financial resources to enhance care quality and member satisfaction.

• Provide extensive care coordination and oversight for members facing behavioral health challenges.

• Conduct thorough health risk and comprehensive needs assessments that encompass psychosocial, physical, medical, behavioral, environmental, and financial aspects.

• Communicate effectively, develop care plans, and act as the main point of contact for service delivery.

• Implement, coordinate, and monitor strategies aimed at improving health and quality-of-life outcomes for members.

• Create, document, and execute plans addressing social, physical, mental, emotional, spiritual, and supportive needs.

• Advocate for members by identifying and resolving gaps in care.

• Oversee care plans and evaluate the effectiveness of interventions.

• Gather clinical path variance data and pinpoint areas for improvement.

• Collaborate with members, families, caregivers, legal representatives, physicians, care providers, ancillary services, and interdisciplinary care teams.

• Educate providers, staff, members, and families about care coordination and health strategies.

• Facilitate the coordinated, cost-effective delivery of quality care across the continuum.

• Assist members with inquiries and concerns about care, providers, or delivery systems.

• Maintain professional relationships with inpatient, outpatient, community, and other external stakeholders.

• Generate reports that align with care coordination objectives.

• Support the orientation and mentoring of new team members as needed.

⛳️ Requirements

• Candidates must reside in Albuquerque, NM or the surrounding area.

• 3-5 years of experience in Social Work, Nursing, Healthcare-related fields, or relevant experience in lieu of a degree.

• Experience in utilization management, quality assurance, home or facility care, community health, long-term care, or occupational health.

• Proven experience in analyzing trends based on decision support systems.

• Business management skills, including cost/benefit analysis, negotiation, and cost containment.

• Knowledge of referral coordination to community and private/public resources.

• Comprehensive understanding of cost-effective care coordination and data interpretation.

• Ability to make decisions that require substantial analysis and investigation.

• Ability to determine appropriate courses of action in complex situations not covered by existing policies or protocols.

• Ability to maintain complete and accurate enrollee records.

• Strong verbal and written communication skills.

• Ability to collaborate with clinicians, hospital officials, and service agency contacts.

• A GED or high school diploma is required.

• A valid in-state driver's license is mandatory.

• Compliance with security responsibilities, legal, regulatory, contractual, and internal policy requirements.

🏝️ Benefits

• Short-term incentives may be available.

• Comprehensive benefits package.

• Health, life, voluntary, and additional benefits.

• Benefits and perks that support physical, mental, emotional, and financial wellbeing.

• Tobacco-free workplace.