Care Coordinator

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

📋 Description

• Oversee client care by conducting assessments, planning care, implementing strategies, coordinating services, monitoring progress, and evaluating outcomes.

• Execute responsibilities either virtually or in-person as per contractual obligations.

• Advocate for the effective use of clinical and financial resources to enhance care quality and elevate member satisfaction.

• Facilitate care coordination for members facing behavioral health challenges that require intensive intervention and supervision.

• Perform thorough health risk evaluations and comprehensive needs assessments addressing psychosocial, physical, medical, behavioral, environmental, and financial aspects.

• Create, communicate, document, and execute care plans, serving as the primary contact for service delivery.

• Implement, coordinate, and monitor initiatives aimed at improving health outcomes and quality of life for members and their families.

• Address the social, physical, mental, emotional, spiritual, and supportive needs of members through suitable resources.

• Identify care gaps and advocate for the needs of members.

• Monitor and assess the effectiveness of care plans and evaluate intervention results.

• Regularly review care plans to pinpoint gaps and trends.

• Gather clinical path variance data to discover opportunities for improvement.

• Work collaboratively with interdisciplinary care plan teams to revise care plans and coordinate services.

• Provide education to providers, staff, members, and families on care coordination and health strategies.

• Promote a team-based, cost-efficient approach to high-quality care throughout the continuum.

• Collaborate with members, caregivers, legal representatives, physicians, care providers, and ancillary services to address medical, behavioral, social, community-based, and long-term care needs.

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

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

• Prepare reports in alignment with care coordination objectives.

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

⛳️ Requirements

• 3 to 5 years of experience in Social Work, Nursing, a Healthcare-related field, or equivalent 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 ability to analyze trends using decision support systems.

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

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

• In-depth understanding of cost-effective care coordination and data analysis.

• Capacity to make decisions that require significant analysis and investigation.

• Ability to determine actions in complex situations not covered by existing policies or protocols.

• Competence in maintaining complete and accurate enrollee records.

• Strong verbal and written communication skills.

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

• GED or high school diploma is required.

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

• Compliance with all applicable legal, regulatory, contractual, and internal policy requirements.

• Preferred certification/licensure includes Certified Case Manager (CCM), Licensed Clinical Social Worker (LCSW), or Registered Nurse (RN) state and/or compact-state licensure.

🏝️ Benefits

• Short-term incentives may be available.

• Comprehensive benefits package.

• Health benefits.

• Life benefits.

• Voluntary benefits.

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

• Tobacco-free workplace.