CISC Care Coordinator - Las Cruces

Magellan Health • Las Cruces, NM

5d • $50,225 - $75,335 • Remote

About The Position

The CISC Care Coordinator coordinates care for clients with behavioral health conditions who require intensive interventions and oversight. The role uses assessment, care planning, implementation, coordination, monitoring, and evaluation to support cost-effective, quality outcomes and member satisfaction. Duties are performed virtually or face-to-face according to contractual requirements. This is a work-from-home position involving extensive travel in the community; candidates must reside in Las Cruces, New Mexico, or the surrounding area.

The coordinator conducts in-depth health-risk and comprehensive needs assessments; develops, communicates, documents, and monitors care plans; advocates for members and identifies gaps in care; and coordinates clinical, social, and community resources. The role works with members, families, caregivers, providers, and interdisciplinary care teams to improve health and quality-of-life outcomes, address member needs, and deliver appropriate, cost-effective services. The coordinator also supports member questions and concerns, maintains professional relationships with external stakeholders, generates reports, and may assist with orienting and mentoring new team members.

The position requires 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 is required. A high school diploma or GED is required; an associate or bachelor's degree and certain case-management or clinical licenses are preferred. A valid in-state driver's license is required.

The anticipated base salary range is $50,225–$75,335, with actual pay varying based on location and individual job-related factors. The position may be eligible for short-term incentives and a comprehensive benefits package.

Requirements

• 3–5 years of experience in social work, nursing, or 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 interpreting data.
• Ability to make decisions requiring significant analysis and investigation and to develop solutions requiring original thinking.
• Ability to determine appropriate courses of action in complex situations not addressed by existing policies or protocols.
• Ability to maintain complete and accurate enrollee records.
• Effective verbal and written communication skills and ability to work well with clinicians, hospital officials, and service-agency contacts.
• High school diploma or GED.
• Valid in-state driver's license.
• Ability to work from home and travel extensively in the community; must reside in Las Cruces, New Mexico, or the surrounding area.

Nice To Haves

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

Responsibilities

• Coordinate care for members with behavioral health conditions requiring intensive interventions and oversight.
• Conduct in-depth health-risk and comprehensive needs assessments, including psychosocial, physical, medical, behavioral, environmental, and financial factors.
• Communicate, develop, document, and implement care plans and serve as a point of contact to ensure services are provided appropriately.
• Coordinate and monitor strategies and resources to improve members’ and families’ health and quality-of-life outcomes.
• Advocate for members by identifying and addressing gaps in care.
• Monitor care plans and measure intervention effectiveness; assess plans regularly and identify trends and opportunities for improvement.
• Collect clinical path variance data related to potential improvements in cases and services.
• Work with members and interdisciplinary care-plan teams to adjust care plans as needed.
• Educate providers, support staff, members, and families about care coordination and health strategies using a member-focused approach.
• Facilitate a team approach to the appropriate, cost-effective delivery of quality care and services across the continuum.
• Collaborate with 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 and 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.
• Assist with orientation and mentoring of new team members as appropriate.
• Maintain complete and accurate enrollee records.

Benefits

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

What This Job Offers

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