Care Coordinator

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

📋 Description

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

• Execute responsibilities either virtually or in-person based on contractual obligations.

• Encourage the proper utilization of clinical and financial resources to enhance care quality and member satisfaction.

• Offer care coordination to members experiencing behavioral health issues that necessitate intensive interventions and oversight.

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

• Create, communicate, document, and implement personalized care plans.

• Act as a liaison to guarantee that services are effectively delivered, including transitions to home care, backup plans, and community-based services.

• Monitor strategies and care plans, assess the effectiveness of interventions, and identify gaps and trends.

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

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

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

• Facilitate the cost-effective provision of quality care throughout the continuum.

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

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

• Support the orientation and mentoring of new team members.

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

• Generate reports aligned with care coordination goals.

⛳️ Requirements

• 3–5 years of experience in Social Work, Nursing, a Healthcare-related field, 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 utilizing decision support systems.

• Business management skills encompassing 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 interpretation.

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

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

• Proficient 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 GED or high school diploma.

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

• Preferred: Associate or Bachelor's degree.

• Preferred certifications/licenses include CCM, LCSW, and RN state and/or compact-state licensure.

• Must adhere to position-specific security responsibilities, controls, legal, regulatory, contractual, and internal policy requirements.

🏝️ Benefits

• Short-term incentives may be available.

• Comprehensive benefits package.

• Health, life, voluntary, and additional benefits and perks.

• Opportunities for professional growth and development.

• Total health and wellness initiatives.

• Rewards and recognition programs.

• Employee unity and camaraderie.

• Tobacco-free workplace.