Care Coordination: Quality and Affordability Specialist

HealthPartners; BLOOMINGTON (MN); On-site; USD 90,000 - 120,000; Full time

Job summary

HealthPartners in Bloomington, MN seeks a Care Coordination Quality and Affordability Specialist to drive affordability, cost stewardship, and appropriate utilization of Elderly Waiver (EW) and Medicaid services. You will analyze MnCHOICES and risk data, close care gaps, and guide services with a focus on financial sustainability and member outcomes.

The role partners with Care Coordinators and leaders to translate cost insights into practical guidance, support IRR scenarios, and ensure

Qualifications

• Bachelor's degree in nursing or social work required.
• Minimum four years in quality improvement or healthcare services.
• Knowledge of Medicaid, EW, LTSS, and care coordination programs.
• RN or SW licensure/certification required.
• MnCHOICES certified assessor preferred.
• Strong data analysis and problem-solving skills.

Responsibilities

• Analyze EW and Medicaid cost and utilization to identify affordability opportunities.
• Use risk scoring and cost data to evaluate assessments for alignment with guidelines.
• Build IRR scenarios and monitor care gaps with leadership partners.
• Translate cost and risk insights into actionable guidance for frontline staff.

Skills

Healthcare cost analysis

Data visualization

Project management

Stakeholder engagement

Evidence-based decision making

Communication & training

Clinical quality improvement

Cost utilization analytics

Education

Bachelor's degree in nursing or social work

Tools

Microsoft Office Suite

MnCHOICES knowledge

Job description

HealthPartners in Bloomington, MN seeks a Care Coordination Quality and Affordability Specialist to drive affordability, cost stewardship, and appropriate utilization of Elderly Waiver (EW) and Medicaid services. You will analyze MnCHOICES and risk data, close care gaps, and guide services with a focus on financial sustainability and member outcomes.

The role partners with Care Coordinators and leaders to translate cost insights into practical guidance, support IRR scenarios, and ensure