Care Coordinator

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

📋 Description

• Facilitate care for specific clients and designated populations through evaluation, care planning, execution, coordination, monitoring, and assessment.

• Deliver care coordination services virtually or in person, adhering to contractual obligations.

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

• Offer care coordination for members experiencing behavioral health issues that necessitate intensive interventions and supervision.

• Conduct thorough health risk and comprehensive needs evaluations encompassing psychosocial, physical, medical, behavioral, environmental, and financial aspects.

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

• Organize and oversee strategies aimed at enhancing health and quality-of-life outcomes for members and their families.

• Recognize and address care gaps, advocating for the healthcare needs of members.

• Oversee care plans and evaluate the effectiveness of interventions.

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

• Collaborate with members and interdisciplinary care plan teams to modify care plans as necessary.

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

• Promote interdisciplinary collaboration and the efficient delivery of high-quality care and services.

• Partner with members, caregivers, legal representatives, physicians, care providers, and additional support services.

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

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

• Generate reports aligned with care coordination objectives.

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

⛳️ Requirements

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

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

• Experience in analyzing trends based on decision support systems.

• Business management abilities, including cost/benefit analysis, negotiation, and cost control.

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

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

• Capability to make decisions requiring substantial analysis and investigation.

• Ability to identify courses of action in complex scenarios not covered by existing policies or protocols.

• Proficiency 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.

• Required education: GED or high school diploma.

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

• Must adhere to applicable legal, regulatory, contractual, and internal policy standards.

• Must comprehend, comply with, and affirm role-specific security responsibilities and controls.

🏝️ Benefits

• Potential eligibility for short-term incentives.

• Comprehensive benefits package.

• Health, life, voluntary, and other benefits.

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

• Tobacco-free workplace.