Care Coordination Quality & Cost Optimization Lead

Socket.dev; BLOOMINGTON (MN); On-site; USD 85,000 - 110,000; Full time

Job summary

HealthPartners is seeking a Care Coordination Quality and Affordability Specialist to drive affordability, cost stewardship, and appropriate utilization of EW and Medicaid services. The role partners with Care Coordinators, HealthPartners leadership, and delegated partners to ensure accurate assessments and cost data-driven guidance.

Responsibilities include analyzing MnCHOICES assessments, building IRR scenarios, and translating insights into actionable guidance to support high-quality member

Qualifications

• Bachelor’s degree in nursing or social work.
• RN or SW licensure.
• MnCHOICES Certified Assessor.

Responsibilities

• Analyze EW and Medicaid spending, cost drivers, and utilization trends.
• Use risk scoring and cost data to evaluate assessments for alignment with MnCHOICES and guidelines.
• Build and analyze MnCHOICES assessments IRR scenarios.
• Identify gaps in care and work with leadership on data-driven improvement strategies.
• Provide coaching to Care Coordinators on cost-effective use of supports.
• Translate financial, risk, and utilization data into actionable insights.
• Liaise between Care Coordination, quality, finance and partners.
• Integrate affordability initiatives with quality improvement and member experience.
• Support planning and execution of initiatives aligned with program goals.

Skills

Cost analysis

Data analysis

Project deliverables

Leadership

Interpersonal skills

Coaching

Microsoft Office

Relationship building

Education

Bachelor’s degree in nursing or social work

RN or SW licensure

MnCHOICES Certified Assessor

Tools

MnCHOICES assessments

Job description

HealthPartners is seeking a Care Coordination Quality and Affordability Specialist to drive affordability, cost stewardship, and appropriate utilization of EW and Medicaid services. The role partners with Care Coordinators, HealthPartners leadership, and delegated partners to ensure accurate assessments and cost data-driven guidance.

Responsibilities include analyzing MnCHOICES assessments, building IRR scenarios, and translating insights into actionable guidance to support high-quality member