Field Care Coordinator - Albuquerque, NM
About The Position
The Field Care Coordinator is the primary care manager for a panel of members with low-to-medium complexity medical and behavioral needs. The role coordinates care addressing members’ medical, behavioral, functional, cultural, and socioeconomic needs to promote appropriate service utilization and improve quality of care. This is a full-time, field-based role with a home-based office. The coordinator works from home when not in the field and travels within an assigned territory to meet members and providers. The schedule is Monday through Friday, 40 hours per week, with flexibility to work an eight-hour shift during normal business hours of 8 a.m. to 5 p.m. Occasional overtime may be necessary. The position is based in or within commuting distance of Albuquerque, New Mexico.
Requirements
- Meet one of the following qualification pathways: a bachelor’s degree or at least 2 years of relevant health care experience; a two-year degree or higher and at least 3 years of clinical experience; an LCSW, LMSW, Licensed Professional Clinical Mental Health Counselor, or LMHC license and at least 3 years of clinical experience; at least 5 years of relevant experience, including 3 years of clinical experience; at least 4 years of experience in a clinical environment, including at least 1 year as a Care Coordinator; or an LPN credential and at least 3 years of clinical experience.
- At least 1 year of experience with Microsoft Office, including Word, Excel, and Outlook.
- Valid driver’s license, access to reliable transportation, and ability to travel up to 50% of the time within the assigned territory to meet members and providers.
- Designated workspace at home with access to high-speed internet.
- Reside in or within commuting distance of Albuquerque, New Mexico.
Nice To Haves
- CCM certification.
- At least 1 year of community case management experience coordinating care for individuals with complex needs.
- Experience working in team-based care.
- Background in managed care.
Responsibilities
- Engage members face-to-face and/or by telephone to complete comprehensive needs assessments covering medical, behavioral, functional, cultural, and socioeconomic needs.
- Develop and implement person-centered care plans addressing chronic conditions, health promotion and wellness, social determinants of health, medication management, and member safety in alignment with evidence-based guidelines.
- Partner and collaborate with internal care teams, providers, and community resources to implement care plans.
- Educate and coach members to support self-management of care needs and lifestyle changes that promote health.
- Support proactive discharge planning and coordinate care transitions after emergency room visits or inpatient or skilled nursing facility admissions.
- Advocate for members and families so members’ needs and choices are represented and supported by the health care team.
- Create positive relationships and experiences with members, using cultural sensitivity and competence in daily care.
- Listen to members’ needs and barriers and encourage self-advocacy and proactive management of their health and health care.
- Collaborate with the clinical team regarding social factors that may affect treatment plans.
- Help members engage with mental health and substance use treatment as needed.
- Provide education on health literacy, community resources, and benefits to encourage self-sufficiency.
- Support members who wish to engage in work or volunteer activities and develop stronger social connections with friends, family, and community.
- Learn about community cultures and values and conduct Comprehensive Needs Assessments (CNAs).
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase program.
- 401(k) contribution.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
