MSHO/MSC+ Care Coordinator

HealthPartners•Bloomington, MN

About The Position

HealthPartners is hiring an MSHO/MSC+ Care Coordinator to support patients, families, and physicians in addressing medical and social concerns; educate and empower patients and families to make informed health care decisions; and facilitate communication among patients, physicians, the health plan, and the community. This 0.80 FTE role is equivalent to 32 hours per week, scheduled Monday through Friday during core business hours. The coordinator directly manages a caseload anticipated to include up to 85 members with complex needs and collaborates with medical, administrative, and front-line staff inside and outside the organization. The role reports directly to the Supervisor, Case Management and makes independent decisions within the position’s accountabilities, using professional clinical judgment and consulting Case Management leadership or the Medical Director when indicated.

Requirements

Must be a Social Worker or Registered Nurse; a BSN is preferred for Registered Nurses.
Must hold a current, unrestricted Minnesota license; license history must be free of restrictions and/or sanctions in the past 10 years in all states where currently or previously licensed.
At least 2 years of home and community-based experience.
Experience with relevant utilization review, discharge planning, or case management.
Current clinical knowledge.
Demonstrated effective independent professional judgment and skills.
Demonstrated ability to collaborate effectively with care team members.
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 MCO 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

Bachelor of Science in Nursing (BSN) for Registered Nurse candidates.

Responsibilities

Provide individualized, member-focused support and identify interventions and resources to help members reach personal health-related goals.
Identify patterns and episodes of care that may predict future member needs and services.
Integrate clinical and psychosocial information for case identification and assessment, and develop and implement action-oriented, time-specific plans and interventions.
Facilitate care integration and effective communication among patients, families, providers, health plan staff, care system programs, and community-based services.
Follow department policies and procedures and coordinate service coverage with appropriate funding sources when indicated.
Work with Case Management, Government Programs, and Member Services leadership and staff to support compliance with Medicare requirements and regulations.
Educate patients and families about health, health care benefits, and the health care system; provide educational information and materials for preference-sensitive decisions.
Communicate routinely with patients, families, physicians, and health care team members to support collaboration and satisfaction.
Report member outcomes to Case Management leadership according to defined processes; promptly report potentially adverse situations and high-cost cases for reinsurance.
Maintain accurate and current documentation and case management files, and protect confidential information in accordance with applicable policies.
Establish and maintain effective working relationships across departments and with other health care team participants; support team members in achieving patient-centered goals.
Contribute to a collaborative, respectful, and diverse Case Management team and participate in appropriate departmental and organizational meetings.
Maintain knowledge of and proficiently use automated applications and systems; identify technology training needs and seek training with supervisor guidance.
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 and recommendations for professional growth and development.
Maintain current, active Minnesota nursing or social work licensure and, if assigned, licensure in other states.
Participate in committees, task forces, projects, and quality improvement teams as needed or assigned, and perform other assigned duties.
Make independent decisions within the position’s scope, determine when to consult Case Management leadership or the Medical Director, and recommend policy development or changes to leadership.