Care Coordinator - Remote in Bernalillo/Rio Rancho, NM

Magellan Health; Rio Rancho (NM); Remote; USD 50,000 - 76,000; Full time

Job summary

An established industry player is seeking a dedicated Care Coordinator to provide exceptional support for clients with behavioral health conditions. This role emphasizes the importance of effective care coordination and involves conducting comprehensive assessments, developing tailored care plans, and collaborating with interdisciplinary teams. The ideal candidate will possess strong analytical skills and a background in social work or nursing. Join a forward-thinking organization that values quality outcomes and member satisfaction, and be part of a team that makes a real difference in people's lives.

Benefits

Health Insurance

Life Insurance

Flexible Work Hours

Professional Development Opportunities

Qualifications

• 3-5 years experience in Social Work, Nursing, or related healthcare fields.
• Skills in analyzing trends and using decision support systems.

Responsibilities

• Coordinates care for clients with behavioral health conditions.
• Develops care plans and monitors their effectiveness.
• Educates stakeholders about care coordination and health strategies.

Skills

Social Work

Nursing

Utilization Management

Quality Assurance

Cost/Benefit Analysis

Data Interpretation

Education

GED

High School Diploma

Associate Degree

Bachelor's Degree

Job description

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 typically performed during face-to-face home visits. Promotes the appropriate use of clinical and financial resources to improve quality of care and member satisfaction. Assists with orientation and mentoring of new team members as appropriate.

1. Provides care coordination to members with behavioral health conditions requiring intensive interventions, including multiple clinical, social, and community resources.
2. Conducts in-depth health risk and comprehensive needs assessments covering psycho-social, physical, medical, behavioral, environmental, and financial parameters.
3. Develops care plans and serves as a point of contact to ensure appropriate service delivery, including during transitions to home care and community-based services.
4. Implements, coordinates, and monitors strategies to improve health and quality of life outcomes for members and families.
5. Creates and documents plans that address social, physical, mental, emotional, spiritual, and supportive needs.
6. Acts as an advocate for members by identifying and addressing gaps in care.
7. Performs ongoing monitoring and evaluation of care plans to assess effectiveness and identify gaps or trends for improvement.
8. Collects data on clinical path variances to identify areas for service improvement.
9. Works with members and interdisciplinary teams to adjust care plans as necessary.
10. Educates providers, staff, members, and families about care coordination and health strategies, emphasizing a member-focused approach.
11. Facilitates teamwork and collaboration across disciplines to ensure appropriate, cost-effective, and quality care delivery.
12. Collaborates with various stakeholders, including members, caregivers, physicians, and support services, to address care issues and specific needs, utilizing licensed staff for complex cases.
13. Provides assistance to members with questions or concerns regarding their care or services.
14. Maintains professional relationships with external healthcare and community resources.
15. Generates reports aligned with care coordination goals.

Other Job Requirements

• 3-5 years experience in Social Work, Nursing, or related healthcare fields, or relevant experience in lieu of a degree.
• Experience in utilization management, quality assurance, home or facility care, community health, long-term care, or occupational health.
• Skills in analyzing trends and using decision support systems.
• Business management skills including cost/benefit analysis, negotiation, and cost containment.
• Knowledge of referral processes to community and private/public resources.
• Understanding of cost-effective care coordination, data interpretation, and decision-making in complex situations.
• Ability to maintain accurate records and communicate effectively with clinical and non-clinical stakeholders.

General Job Information

• Title: Care Coordinator - Remote in Bernalillo/Rio Rancho, NM
• Grade: 22
• Work Experience - Required: Clinical, Quality
• Work Experience - Preferred:

Education

• Required: GED, High School
• Preferred: Associate, Bachelor's

License and Certifications

• Required: Driver License - Valid In-State
• Preferred: CCM, LCSW, RN, State/Compact Licensure

Salary Range

Minimum: $50,225

Maximum: $75,335

This range reflects current national data and may vary based on location, skills, experience, and other factors. Actual pay will be adjusted accordingly. The position may be eligible for incentives and a comprehensive benefits package, including health, life, and other perks.

Magellan Health, Inc. is an Equal Opportunity Employer and Tobacco-Free workplace. All employees must adhere to security and legal requirements.