Care Coordinator – CISC

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

📋 Description

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

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

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

• Offer care coordination for members with behavioral health issues that necessitate intensive interventions and oversight.

• Conduct thorough health risk evaluations and comprehensive needs assessments.

• Communicate and formulate care plans while acting as the primary contact to ensure services are delivered appropriately.

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

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

• Advocate for members by recognizing and addressing gaps in care.

• Monitor care plans and assess the effectiveness of interventions.

• Regularly review care plans and gather clinical path variance data for enhancement.

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

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

• Facilitate a team-oriented, cost-effective approach to delivering quality care and services.

• Work alongside members, caregivers, legal representatives, physicians, care providers, and ancillary support services.

• Provide support for 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.

• Assist in the orientation and mentoring of new team members as required.

⛳️ Requirements

• 3-5 years of experience in Social Work, Nursing, Healthcare-related fields, or equivalent 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 using decision support systems.

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

• Familiarity with referral coordination to community and private/public resources.

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

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

• Ability to determine appropriate actions in complex situations.

• Competence in maintaining thorough 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 necessary.

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

🏝️ Benefits

• Potential availability of short-term incentives.

• Comprehensive benefits package.

• Includes health, life, voluntary, and other benefits.

• Benefits and perks promoting physical, mental, emotional, and financial wellbeing.

• Tobacco-free workplace.