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 according to contractual obligations.

• Supply care coordination for members with behavioral health conditions that necessitate intensive interventions and oversight.

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

• Communicate effectively and formulate care plans, serving as the primary contact for service delivery.

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

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

• Advocate for members by recognizing and addressing care gaps.

• Supervise care plans and assess the effectiveness of interventions.

• Regularly review plans to identify gaps and trends for improvement.

• Collect clinical path variance data to pinpoint areas needing enhancement.

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

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

• Facilitate a team-based, cost-effective approach to delivering quality care across the continuum.

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

• Engage licensed care coordination staff for complex cases when appropriate.

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

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

• Generate reports that align with care coordination objectives.

• Travel extensively within the community while working from home.

⛳️ Requirements

• Applicants must reside in the Rio Rancho, NM or nearby area.

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

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

• Proficient in analyzing trends based on decision support systems.

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

• Knowledgeable about referral coordination to community and private/public resources.

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

• Capable of making decisions that require significant analysis and investigation.

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

• Skilled in maintaining complete and accurate enrollee records.

• Strong verbal and written communication skills.

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

• Required education: GED or high school diploma.

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

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

🏝️ Benefits

• Short-term incentives may be accessible.

• Comprehensive benefits package offered.

• Health, life, voluntary, and various other benefits.

• A range of benefits and perks promoting physical, mental, emotional, and financial wellbeing.

• Tobacco-free workplace.