Resident Care Coordinator

Care Coordinator (Grants,NM/ Gallup,NM)Coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes. Duties are performed virtually or face-to-face based on contractual requirements. Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Assists with orientation and mentoring of new team members as appropriate.Responsibilities include:Providing care coordination to members with behavioral health conditions requiring intensive interventions and oversightConducting in-depth health risk assessments and comprehensive needs assessmentsCommunicating and developing care plans and serving as point of contact to ensure services are rendered appropriatelyImplementing, coordinating, and monitoring strategies for members and families to improve health and quality of life outcomesDeveloping, documenting, and implementing plans to address social, physical, mental, emotional, spiritual, and supportive needsActing as an advocate for member’s care needs by identifying and addressing gaps in carePerforming ongoing monitoring of the plan of care to evaluate effectivenessMeasuring the effectiveness of interventions as identified in the members care planAssessing and reviewing plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomesCollecting clinical path variance data that indicates potential areas for improvement of case and services providedWorking with members and the interdisciplinary care plan team to adjust plan of care, when necessaryEducating providers, supporting staff, members, and families regarding care coordination role and health strategies with a focus on member-focused approach to careFacilitating a team approach to the coordination and cost-effective delivery to quality care and servicesCollaborating with the interdisciplinary care plan team to address care issues, specific member needs and disease processesProviding assistance to members with questions and concerns regarding care, providers or delivery systemMaintaining professional relationship with external stakeholders, such as inpatient, outpatient and community resourcesGenerating reports in accordance with care coordination goalOther job requirements include:3-5 years' experience in Social Work, Nursing, or Healthcare-related field, or relevant experience in lieu of degreeExperience in utilization management, quality assurance, home or facility care, community health, long term care or occupational healthExperience in analyzing trends based on decision support systemsBusiness management skills to include, but not limited to, cost/benefit analysis, negotiation, and cost containmentKnowledge of referral coordination to community and private/public resourcesAbility to make decisions that require significant analysis and investigation with solutions requiring significant original thinkingAbility to determine appropriate courses of action in more complex situations that may not be addressed by existing policies or protocolsAbility to maintain complete and accurate enrollee recordsEffective verbal and written communication skillsAbility to work well with clinicians, hospital officials and service agency contactsSalary range: $50,225 - $75,335This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.