Care Coordinator II - LCMC

Presbyterian Healthcare Services; Framingham (MA); On-site; USD 57,000 - 97,000; Full time

Benefits offered by this job

Tuition reimbursement

Certification reimbursement

Wearable safety badge

Loan forgiveness

Malpractice insurance

Job summary

Presbyterian Healthcare Services is hiring a skilled Care Coordinator II to join our care coordination team in New Mexico. The role focuses on team-based planning, cost-effective delivery, and quality outcomes across medical, behavioral, social, and long-term care services.

Responsibilities include coordinating care, supporting patients in hospital, clinic settings, and during transitions, while engaging with interdisciplinary teams to address patient needs and optimize outcomes.

Qualifications

• Associates Degree; 3 years experience can substitute for degree; Bachelor's preferred.
• 2 years of related experience.
• Valid driver license, clean driving record, and ability to travel locally.
• Experience in utilization management, quality assurance, home care, community health, long term care or occupational health.
• CCM certification preferred or obtainable within 3 years of hire.
• Proficiency in Word, Excel and Outlook.
• Experience in analyzing trends based on decision support systems.
• Cost/benefit analysis and negotiation skills.
• Knowledge of referral coordination to community and public resources.

Responsibilities

• Facilitates a team approach to ensure interventions and cost effective quality care.
• Collaborates with interdisciplinary care plan team including members, caregivers, physicians and providers.
• Coordinates care for identified populations using assessment, planning, implementation, coordination, monitoring and evaluation.
• Provides care coordination to members with chronic conditions and less complex needs.
• Performs home visits as required.
• Educates providers and staff on care coordination and health strategies.
• Maintains relationships with external stakeholders and promotes appropriate use of resources.
• Generates reports and participates in Interdisciplinary Care Team meetings.

Skills

Driver license

Travel locally

CCM certification

Data analysis

Cost/benefit analysis

Referral coordination

Education

Associates Degree

Bachelor's degree preferred

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Location Address:

211 Sudderth Dr Ruidoso, NM 88345-6002

Compensation Pay Range:

Minimum Offer $27.52Maximum Offer $46.86

Summary:

Build your Career. Make a Difference. Presbyterian is hiring a skilled Care Coordinator II

How you grow, learn and thrive matters here.

• Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
• Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
• Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
• Malpractice liability insurance
• Loan forgiveness through the New Mexico Higher Education Department
• EPIC electronic charting system

Type of Opportunity: Full timeFTE: 0.90Job Exempt: NoWork Shift: 10 Hour Days (United States of America)

Responsibilities:

Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, members 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. 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

Some key responsibilities include

• Supports patients in a hospital and inpatient or clinic setting
• Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates 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.
• Provides care coordination to members with chronic condition with less complex needs including less community resources. Conducts in depth health risk assessment and/or comprehensive needs assessment which include but not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters. Develops and communicates plan for authorization of services, and serves as point of contact to ensure services are rendered appropriately, i.e. during transition to home care, back up plans, community based services.
• Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; collects clinical path variance data that indicates potential areas for improvement of case and services provided; works with members and the interdisciplinary care plan team to adjust plan of care, when necessary.
• Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes. Develops, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for member s care needs by identifying and addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan.
• Provides assistance to members with questions and concerns regarding care, providers or delivery system.
• Conducts face to face home visits, as required.
• Educates providers, support staff, members and families regarding care coordination role and health strategies with a focus on member focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services.
• Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.
• Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Generates reports in accordance with care coordination goals.
• Participates in Interdisciplinary Care Team (ICPT) meetings.
• Assists with orientation and mentoring of new team members as appropriate.
• Performs other functions as required.

Qualifications:

• Associates Degree, 3 years of additional experience can be substituted in lieu of an Associates Degree. Bachelors degree preferred.
• 2 years of related experience.
• Must have a valid driver license, clean driving record, and able to travel locally.
• Experience in utilization management, quality assurance, home care, community health, long term care or occupational health required.
• CCM certification preferred or must obtain within 3 years of hire.
• Proficiency in Microsoft Word, Excel and Outlook 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 & private and public resources.

We’re all about well-being, starting with yours.

Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.

Learn more about our employee benefits.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state’s largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.

We’re Determined to Support New Mexico’s Well-Being | Presbyterian Healthcare Services