Care Coordinator - Roswell, NM

Military Spouse Corporate Career Network • Roswell, NM

6d • Onsite

About The Position

Coordinates care for individual clients in identified populations through assessment, care planning, implementation, coordination, monitoring, and evaluation to support cost-effective, quality outcomes. Duties may be performed virtually or face-to-face based on contractual requirements. The role promotes appropriate use of clinical and financial resources to improve quality of care and member satisfaction, and may assist with orientation and mentoring of new team members.

Provides care coordination for members with behavioral health conditions requiring intensive interventions and oversight involving clinical, social, and community resources. Conducts in-depth health risk and comprehensive needs assessments covering psychosocial, physical, medical, behavioral, environmental, and financial factors. Develops and communicates care plans, serves as a point of contact, coordinates services, monitors outcomes, identifies gaps in care, and advocates for members. Works with members, families, caregivers, providers, and interdisciplinary care teams to address needs and adjust plans as appropriate. Educates members and stakeholders, maintains professional relationships with external resources, and generates reports in accordance with care coordination goals. The listed duties are representative and not exhaustive; additional duties aligned with the role may be assigned.

Requirements

• 3–5 years of experience in social work, nursing, a healthcare-related field, or relevant experience in lieu of a degree.
• Experience in utilization management, quality assurance, home or facility care, community health, long-term care, or occupational health.
• Experience 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 care coordination, including what work is done, how and why it is done, and interpretation of data.
• Ability to make decisions requiring significant analysis and investigation, with solutions requiring significant original thinking.
• Ability to determine appropriate courses of action in complex situations that may not be addressed by existing policies or protocols.
• Effective verbal and written communication skills.
• Ability to work well with clinicians, hospital officials, and service agency contacts.
• Valid in-state driver's license.
• Required education: GED or high school education.

Nice To Haves

• Associate or bachelor's degree.
• Certified Case Manager (CCM).
• Licensed Clinical Social Worker (LCSW).
• Registered Nurse (RN) with state and/or compact state licensure.

Responsibilities

• Coordinate client care through assessment, care planning, implementation, coordination, monitoring, and evaluation.
• Promote appropriate use of clinical and financial resources to improve care quality and member satisfaction.
• Assist with orientation and mentoring of new team members as appropriate.
• Provide intensive care coordination for members with behavioral health conditions and complex clinical, social, and community resource needs.
• Conduct in-depth health risk and comprehensive needs assessments, including psychosocial, physical, medical, behavioral, environmental, and financial parameters.
• Develop and communicate care plans and serve as a point of contact to ensure services are appropriately rendered, including during transitions to home care and coordination of backup plans and community services.
• Implement, coordinate, and monitor strategies for members and families to improve health and quality-of-life outcomes.
• Develop, document, and implement plans addressing social, physical, mental, emotional, spiritual, and supportive needs.
• Advocate for members by identifying and addressing gaps in care.
• Monitor plans of care, measure intervention effectiveness, and regularly review plans to identify gaps and trends.
• Collect clinical path variance data to identify potential areas for improvement in cases and services.
• Work with members and interdisciplinary care plan teams to adjust plans of care when necessary.
• Educate providers, support staff, members, and families about care coordination and health strategies using a member-focused approach.
• Facilitate team-based, cost-effective delivery of quality care and services across the continuum.
• Collaborate with interdisciplinary care teams, including members, caregivers, legal representatives, physicians, care providers, and ancillary support services, to address care issues and member needs.
• Use licensed care coordination staff as appropriate for complex cases.
• Assist members with questions or concerns about care, providers, or the delivery system.
• Maintain professional relationships with inpatient, outpatient, and community stakeholders.
• Generate reports in accordance with care coordination goals.
• Maintain complete and accurate enrollee records.

Benefits

• Comprehensive benefits package.
• Health, life, voluntary, and other benefits and perks supporting physical, mental, emotional, and financial wellbeing.
• May be eligible for short-term incentives.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED