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Care Coordinator, Licensed

2 months ago

Clovis, New Mexico, United States VetJobs Full time
About the Role

We are seeking a highly skilled Care Coordinator, Licensed to join our team at VetJobs. As a key member of our healthcare team, you will play a critical role in coordinating care for our clients, ensuring they receive the highest quality of care and services.

Key Responsibilities
  • Independently coordinate care for individual clients, utilizing assessment, care planning, implementation, coordination, monitoring, and evaluation to achieve cost-effective and quality outcomes.
  • Perform duties during face-to-face home visits or facility-based assignments, depending on the client's needs.
  • Promote the appropriate use of clinical and financial resources to improve the quality of care and member satisfaction.
  • Assist with the orientation and mentoring of new team members as needed.
  • May act as a team lead for non-licensed care coordinators.
  • Provide care coordination to members with behavioral health conditions requiring intensive interventions and oversight, including multiple clinical, social, and community resources.
  • Conduct in-depth health risk assessments and comprehensive needs assessments, including psycho-social, physical, medical, behavioral, environmental, and financial parameters.
  • Communicate and develop care plans, serving as the point of contact to ensure services are rendered appropriately.
  • Implement, coordinate, and monitor strategies to improve health and quality of life outcomes for members and their families.
  • Develop, document, and implement plans that provide appropriate resources to address social, physical, mental, emotional, spiritual, and supportive needs.
  • Act as an advocate for members' care needs by identifying and addressing gaps in care.
  • Perform ongoing monitoring of care plans to evaluate effectiveness and measure the effectiveness of interventions as identified in the members' care plans.
  • Assess and review care plans regularly to identify gaps in care, trends to improve health and quality of life outcomes, and collect clinical path variance data to identify potential areas for improvement.
  • Work with members and the interdisciplinary care plan team to adjust care plans as needed.
  • Educate providers, supporting staff, members, and families regarding care coordination roles and health strategies, focusing on a member-centered approach to care.
  • Facilitate a team approach to the coordination and cost-effective delivery of quality care and services.
  • Collaborate with the interdisciplinary care plan team, including members, caregivers, legal representatives, physicians, care providers, and ancillary support services, to address care issues, specific member needs, and disease processes.
Requirements
  • Associate's Degree in Nursing required for RNs, or Master's Degree in Social Work or a healthcare-related field, with an independent license, for Social Workers.
  • Licensed in the state where services are performed and meets Magellan Credentialing criteria.
  • 2+ years of post-licensure clinical experience.
  • Experience in utilization management, quality assurance, home or facility care, community health, long-term care, or occupational health.
  • Experience in analyzing trends based on decision support systems.
  • Business management skills, including cost/benefit analysis, negotiation, and cost containment.
  • Detailed knowledge of cost-effective coordination of care, including interpretation of data.
  • Ability to make decisions that require significant analysis and investigation, with solutions requiring significant original thinking.
  • Ability to determine appropriate courses of action in complex situations that may not be addressed by existing policies or protocols.
  • Ability to establish strong working relationships with clinicians, hospital officials, and service agency contacts.
  • Computer literacy desired.
  • Ability to maintain complete and accurate enrollee records.
  • Effective verbal and written communication skills.