Care Coordinator

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

📋 Description

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

• Perform tasks virtually or in-person in accordance with contractual obligations.

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

• Provide care coordination for members with behavioral health issues necessitating intensive interventions and supervision.

• Conduct thorough health risk assessments and comprehensive needs evaluations.

• Communicate and formulate care plans while acting as the main point of contact to ensure proper service delivery.

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

• Develop, document, and execute plans that address social, physical, mental, emotional, spiritual, and supportive needs.

• Advocate for members by identifying and addressing care gaps.

• Monitor care plans and assess the effectiveness of interventions.

• Review care plans to detect gaps and trends.

• Collect clinical path variance data to enhance case and service quality.

• Collaborate with members and interdisciplinary care planning teams to modify care plans as needed.

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

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

• Work in partnership with members, caregivers, legal representatives, physicians, care providers, and ancillary support services.

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

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

• Generate reports that align with care coordination objectives.

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

⛳️ Requirements

• 3-5 years of experience in Social Work, Nursing, or a Healthcare-related field, or equivalent relevant experience in place of a degree.

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

• Proficiency in analyzing trends based on decision support systems.

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

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

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

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

• Capacity to determine suitable courses of action in complex scenarios.

• Ability to maintain comprehensive and accurate enrollee records.

• Strong verbal and written communication skills.

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

• GED or high school diploma is required.

• Valid in-state driver’s license is necessary.

• Adherence to security obligations, relevant legal, regulatory, and contractual requirements, as well as internal policies and procedures.

🏝️ 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 well-being.

• Tobacco-free workplace.