Care Coordinator

Care Coordinator (Eddy County, Lea County, Chaves County)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 oversight.Conducting in-depth health risk assessments and comprehensive needs assessments.Communicating and developing care plans and serving as point of contact to ensure services are rendered appropriately.Implementing, coordinating, and monitoring strategies for members and families to improve health and quality of life outcomes.Developing, documenting, and implementing plans which provide appropriate resources to address social, physical, mental, emotional, spiritual, and supportive needs.Acting as an advocate for member’s care needs by identifying and addressing gaps in care.Performing ongoing monitoring of the plan of care to evaluate effectiveness.Measuring the effectiveness of interventions as identified in the members care plan.Assessing and reviewing plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes.Collecting clinical path variance data that indicates potential areas for improvement of case and services provided.Working with members and the interdisciplinary care plan team to adjust plan of care, when necessary.Educating providers, supporting staff, members, and families regarding care coordination role and health strategies with a focus on member-focused approach to care.Facilitating a team approach to the coordination and cost-effective delivery to quality care and services.Collaborating with the interdisciplinary care plan team to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum.Collaborating with the interdisciplinary care plan team which may include member, caregivers, member’s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long-term care services. Utilizing licensed care coordination staff as appropriate for complex cases.Providing assistance to members with questions and concerns regarding care, providers or delivery system.Maintaining professional relationship with external stakeholders, such as inpatient, outpatient and community resources.Generating reports in accordance with care coordination goal.Other job requirements include:3-5 years' experience in Social Work, Nursing, or Healthcare-related field, or relevant experience in lieu of degree. 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 to include, but not limited to, cost/benefit analysis, negotiation, and cost containment. Knowledge of referral coordination to community and private/public resources. Requires detailed knowledge of cost-effective coordination of care in terms of what and how work is to be done as well as why it is done, this level includes 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 more complex situations that may not be addressed by existing policies or protocols. Decisions include such matters as changing in staffing levels, order in which work is done, and application of established procedures. Ability to maintain complete and accurate enrollee records. Effective verbal and written communication skills. Ability to work well with clinicians, hospital officials and service agency contacts.Salary Range: $50,225 - $75,335 Magellan Health