Care Coordinator, LSW
3 weeks ago
At Bluestone Physician Services, we pride ourselves on delivering exceptional care to patients living with complex, chronic conditions and disabilities. Our unique model of care brings together multidisciplinary teams to provide preventative, proactive, and tailored care that meets the unique needs of each patient.
Our Care Coordination ModelWe have a highly developed care coordination model that supports over 14,000 seniors and individuals living with disabilities in Minnesota. Our care coordinators work directly with patients to assess their physical, mental, and social needs and facilitate services and communication across their care team to support their best interests and close gaps in care.
Job OverviewWe are seeking a Care Coordinator to join our team, where you will work with the senior population managing Department of Human Services (DHS) and Center for Medicare/Medicaid Services (CMS) required activities for Minnesota Senior Health Options (MSHO/MSC+) members living in the community and assisted living facilities.
Responsibilities- Coordinating face-to-face visits with patients
- Managing the Elderly Waiver program
- Conducting annual assessments, including Personal Care Assistance (PCA) assessments for community members and customized living tools for members residing in Assisted Living facilities
- Reviewing current health needs, identifying goals, and developing individualized care plans
- Helping connect patients with community and state resources and services
- Completing required documentation
- Collaborating with medical care teams to ensure health care quality measures are met and use utilization management tools to meet value-based goals
- Supporting patients during transitions of care and collaborating with their care team to ensure a safe discharge and follow-up plan
- MN Licensed Social Worker (new grads encouraged to apply)
- OR Current Minnesota Registered Nurse license
- One or more years of experience working with the geriatric population in case management/care coordination, Home Care, Nursing Home, TCU, or Assisted Living settings preferred
- Must have a valid driver's license
- Health Insurance
- Dental Insurance
- Vision Materials Insurance
- Company-paid Life Insurance
- Company-paid Short and Long-term Disability
- Health Savings Account (with employer contribution)
- Flexible Spending Account (FSA)
- Retirement plan with 4% matching contributions
- Eight (8) paid holidays for office closures plus two (2) floating holidays
- Three weeks (15 Days) Paid Time Off (PTO)
- Mileage reimbursement program for field employees
- Company-sponsored cell phone, laptop, and scrubs
- Regular business hours
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