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Care Coordinator

2 months ago

Albuquerque, New Mexico, United States National Guard Employment Network Full time
Care Coordinator, Licensed

Job Summary:

We are seeking a highly skilled Care Coordinator, Licensed to join our team at National Guard Employment Network. As a Care Coordinator, you will play a critical role in coordinating care for individual clients, working with identified populations to assess, plan, implement, coordinate, monitor, and evaluate care to achieve cost-effective and quality outcomes.

Key Responsibilities:

  • Independently coordinate care for individual clients, applying assessment, care planning, implementation, coordination, monitoring, and evaluation to achieve cost-effective and quality outcomes.
  • Promote the appropriate use of clinical and financial resources to improve the quality of care and member satisfaction.
  • Assist with orientation and mentoring of new team members as needed.
  • Act as a team lead for non-licensed care coordinators.
  • Provide care coordination to members with behavioral health conditions requiring intensive interventions and oversight.
  • 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 for members and families to improve health and quality of life outcomes.
  • 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, identifying and addressing gaps in care.
  • Perform ongoing monitoring of the plan of care to evaluate effectiveness and measure the effectiveness of interventions as identified in the members' care plan.
  • Assess and review the plan of care regularly to identify gaps in care and trends to improve health and quality of life outcomes.
  • Collect clinical path variance data to identify potential areas for improvement of case and services provided.
  • Work with members and the interdisciplinary care plan team to adjust the plan of care as needed.
  • Educate providers, supporting staff, members, and families regarding care coordination roles and health strategies, focusing on a member-focused approach to care.
  • Facilitate a team approach to the coordination and cost-effective delivery of quality care and services.

Requirements:

  • Associate's Degree in Nursing required for RNs, or Master's Degree in Social Work or 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' post-licensure clinical experience.
  • Experience in utilization management, quality assurance, home or facility care, community health, long-term care, or occupational health required.
  • 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.

Additional Qualifications/Responsibilities:

Other Job Requirements:

Responsibilities:

We are an equal opportunity employer and welcome applications from diverse candidates. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.