Care Coordinator- Licensed

Magellan Health • Albuquerque, NM

398d • $58,440 - $58,440

About The Position

The Care Coordinator - Licensed is responsible for independently coordinating care for individual clients, focusing on identified populations. This role involves assessment, care planning, implementation, coordination, monitoring, and evaluation to achieve cost-effective and quality outcomes. The position requires interaction with clients through home visits or facility-based assignments, promoting the appropriate use of clinical and financial resources to enhance care quality and member satisfaction. Additionally, the Care Coordinator may mentor new team members and lead non-licensed care coordinators.

Requirements

• Associate's Degree in Nursing required for RNs, or Master's Degree in Social Work or Healthcare-related field with an independent license for Social Workers.
• Licensed in the state where services are performed and meets Magellan Credentialing criteria.
• 2+ years' post-licensure clinical experience.
• Experience in utilization management, quality assurance, home or facility care, community health, long-term care, or occupational health required.
• Experience in analyzing trends based on decision support systems.
• Business management skills including cost/benefit analysis, negotiation, and cost containment.
• Knowledge of referral coordination to community and private/public resources.
• Detailed knowledge of cost-effective coordination of care and data interpretation.
• Ability to make decisions requiring significant analysis and original thinking.
• Ability to determine appropriate courses of action in complex situations.
• Ability to establish strong working relationships with clinicians and service agency contacts.
• Computer literacy desired.
• Ability to maintain complete and accurate enrollee records.
• Effective verbal and written communication skills.

Nice To Haves

• Experience in behavioral health care coordination.
• Familiarity with community resources and support services.

Responsibilities

• Independently coordinates care of individual clients using assessment, care planning, implementation, coordination, monitoring, and evaluation.
• Promotes appropriate use of clinical and financial resources to improve care quality and member satisfaction.
• Assists with orientation and mentoring of new team members.
• Provides care coordination to members with behavioral health conditions requiring intensive interventions.
• Conducts in-depth health risk assessments and comprehensive needs assessments.
• Communicates and develops care plans, ensuring services are rendered appropriately.
• Implements, coordinates, and monitors strategies to improve health and quality of life outcomes for members and families.
• Develops, documents, and implements plans addressing social, physical, mental, emotional, spiritual, and supportive needs.
• Acts as an advocate for members' care needs by identifying and addressing gaps in care.
• Performs ongoing monitoring of the plan of care to evaluate effectiveness and measures the effectiveness of interventions.
• Assesses and reviews the plan of care regularly to identify gaps in care and trends for improvement.
• Collects clinical path variance data to identify areas for improvement in case and services provided.
• Works with members and the interdisciplinary care plan team to adjust the plan of care as necessary.
• Educates providers, supporting staff, members, and families regarding care coordination roles and health strategies.
• Facilitates a team approach to the coordination and cost-effective delivery of quality care and services.
• Collaborates with the interdisciplinary care plan team to address care issues and specific member needs.

Benefits

• Comprehensive health benefits package including health, life, and voluntary benefits.
• Short-term incentives based on performance.
• Opportunities for professional development and training.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Ambulatory Health Care Services
• Education Level: Associate degree