Care Coordinator, LSW (MSHO) - $2,500 Sign-On Bonus

Bluestone

Winona (MN)

On-site

USD 65,000 - 75,000

Full time

14 days+

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Benefits offered by this job

Health Insurance

Dental Insurance

Vision Materials Insurance

Company paid Life Insurance

Company paid Short and Long-term Dis.

Health Savings Account (with employer)

Flexible Spending Account (FSA)

Retirement plan with 4% matching

9 paid holidays + 1 floating holiday

3 weeks PTO (15 days)

Mileage reimbursement

Company sponsored cell phone, laptop

Regular business hours

Job summary

Bluestone seeks a Care Coordinator to manage DHS and CMS requirements for Minnesota Senior Health Options members living in the community and assisted living facilities. The role is remote with local travel and regular visits to patients, from home offices to community settings.

The position emphasizes independent work, strong communication, and coordination with multidisciplinary teams to ensure safe transitions and high-quality care. Travel is 50–70% with 30–50% remote work.

Qualifications

Current MN Licensed Social Worker (new grads encouraged to apply).
OR Minnesota Registered Nurse license.
One or more years of experience with geriatric or disabled populations in case management/care coordination, Home Care, Group Homes, Nursing Homes, TCU or Assisted Living settings preferred.
Must have a valid driver's license.

Responsibilities

Coordinating face-to-face visits.
Managing the Elderly Waiver.
Conducting annual assessments including PCA assessments for community members and customized living tools for Assisted Living residents.
Reviewing health needs, identifying goals, and developing individualized care plans.
Helping connect members with community and state resources and services.
Completing required documentation.
Collaborating with medical care teams to ensure quality measures and use utilization management tools for value-based goals.
Supporting members during transitions of care and ensuring safe discharge and follow-up.

Skills

Independent work

Communication

Customer service

Problem solving

English proficiency

Education

MN Licensed Social Worker

MN RN license

Tools

Driver's license

Job description

Bluestone delivers great outcomes by bringing exceptional care to patients living with complex, chronic conditions and disabilities. Our unique, robust model of care goes beyond primary care services — our multidisciplinary care teams collaborate with patients, their families and other healthcare providers to deliver care that is preventative, proactive and tailored to their unique needs.

Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage patients' chronic conditions, address social determinants of health, manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone patients experienced 21% fewer ER visits, 36% fewer hospitalizations and 41% fewer hospital readmissions compared to patients with similar conditions and complexities over the same time period.

Our care teams travel directly to patients who reside in Assisted Living, Memory Care and Group Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our corporate offices in Stillwater, Minnesota, and Tampa, Florida.

Our success is only possible through the hard work of our employees who bring our core values of Dedication, Excellence, Collaboration and Caring to life every day. Bluestone has been named to the Star Tribune's Top Workplace list for the 14th year in a row! Bluestone also achieved Top Workplace USA 2021-2026! In 2022, Bluestone Accountable Care Organization (ACO) was the best performing ACO in the country as measured by the overall savings per Medicare beneficiary.

Position Overview

Join our team as a Care Coordinator where you will work with the senior population managing Department of Human Services (DHS) and Center for Medicare/Medicaid Services (CMS) required activities for Minnesota Senior Health Options (MSHO/MSC+) members living in the community and assisted living facilities. In this position, you will work from home, but regularly travel your local area to serve the needs of your members and your community.

Schedule

Full time position, day shift hours, no evenings, weekends or holidays. Hours are 8am to 5pm Monday thru Thursday & 8am to 3pm on Fridays.

Location

~50-70% travel throughout the Winona, MN area and ~30-50% remote work.

Salary Range

$65,000 - $75,000. Salary commensurate with experience.

Responsibilities

Coordinating face-to-face visits
Managing the Elderly Waiver
Conducting annual assessments including Personal Care Assistance (PCA) assessments for community members and customized living tools for members residing in Assisted Livings
Reviewing current health needs, identifying goals, and developing individualized care plans
Helping connect members with community and state resources and services
Completing required documentation
Collaborating with medical care teams to ensure health care quality measures are met and use utilization management tools to meet value-based goals
Supporting members during transitions of care as well as collaborating with their care team to ensure a safe discharge and follow up plan

Qualifications

Education/Certification/Experience

Current MN Licensed Social Worker (new grads encouraged to apply)
OR Minnesota Registered Nurse license
One or more years of experience working with the geriatric or certified disabled population in case management/care coordination, Home Care, Group Homes, Nursing Homes, TCU or Assisted Living settings preferred
Must have a valid driver's license

Knowledge/Skills/Abilities