MSHO/MSC+ Care Coordinator

HealthPartners Clinic Stillwater•Bloomington, MN

7d•$36 - $55

About The Position

The MSHO/MSC+ Care Coordinator supports patients, families, and physicians in addressing medical and social concerns; educates and empowers patients and families to make informed personal health care decisions; and facilitates communication among patients, physicians, the health plan, and the community. The role provides individualized, member-focused care coordination, integrates clinical and psychosocial information into assessments and action-oriented plans, and connects members with appropriate interventions, services, and funding sources. The coordinator manages a caseload of up to 85 members with complex needs and collaborates with medical, administrative, and frontline staff inside and outside the organization. The position makes independent decisions within its accountabilities, using professional judgment and organizational and industry knowledge, and consults Case Management leadership and/or the Medical Director when indicated. It reports to the Supervisor, Case Management. This is a 0.80 FTE role, equivalent to 32 hours per week, scheduled Monday through Friday during core business hours. HealthPartners describes itself as a nonprofit integrated health care organization and offers a comprehensive benefits package intended to support health, time off, retirement planning, and continuous learning.

Requirements

Current, unrestricted Minnesota license as a social worker or registered nurse; licensure must be free of restrictions or sanctions during the past 10 years in all states where the applicant is or has been licensed.
At least 2 years of home and community-based experience.
Experience in relevant utilization review, discharge planning, or case management, and current clinical knowledge.
Demonstrated effective independent professional judgment and skills.
Demonstrated experience collaborating with care team members and strong written, oral, and interpersonal communication skills.
Working knowledge of quality improvement, utilization management, MSHO/MSC+ plans, and fiscal management; understanding of the health care and/or managed care organization industry.
Flexibility, organization, and appropriate decision-making in challenging situations.
MnCHOICES Assessor Certification in place or obtained within 3 months of hire.
Basic computer skills.

Nice To Haves

BSN preferred for registered nurse applicants.

Responsibilities

Provide individualized, member-focused support and identify interventions and resources that help members reach personal health-related goals.
Identify patterns and episodes of care that may predict future needs and services.
Integrate clinical and psychosocial information to identify cases, assess patients, and develop time-specific plans and appropriate interventions.
Facilitate communication and integration of care among patients, families, providers, the health plan, health system programs, and community-based services.
Follow departmental policies and procedures and coordinate service coverage with appropriate funding sources when indicated.
Work with Case Management leadership, Government Programs, and Member Services to support compliance with Medicare requirements and regulations.
Educate patients and families about health, health care benefits, and the health care system; provide educational materials for preference-sensitive decisions.
Communicate routinely with patients, families, physicians, and care team members to support collaboration and satisfaction.
Report member outcomes to Case Management leadership, promptly report potentially adverse situations, and identify high-cost cases for reinsurance.
Maintain accurate documentation and case management files, and protect confidential information in accordance with applicable policies.
Establish and maintain working relationships across the Comprehensive Care Advocacy department, HealthPartners departments, and other health team participants; support team members and contribute to a collaborative, respectful, and diverse environment.
Participate in relevant departmental and organizational meetings, committees, task forces, projects, and quality improvement teams as assigned.
Use automated applications and systems effectively, seek training when technology-literacy gaps are identified, and maintain productivity through proficient system use.
Pursue ongoing independent study and professional education to maintain and increase knowledge of case management, patient care services, and benefit packages; respond constructively to feedback.
Maintain current, active Minnesota nursing or social work licensure and, when assigned, licensure in other states.
Make independent decisions within the position’s accountabilities and determine when to consult Case Management leadership and/or the Medical Director.
Use professional clinical judgment and make recommendations to leadership regarding policy development or changes.
Perform other duties as assigned.