Care Coordinator, RN (MSHO)

Bluestone; Saint Paul (MN); Hybrid; USD 65,000 - 75,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Materials Insurance

Company-paid Life Insurance

Company-paid Short and Long-term Disab

Health Savings Account (employer)

Flexible Spending Account (FSA)

Retirement plan with 4% matching

Paid holidays and PTO

Mileage reimbursement

Cell phone, laptop, scrubs

Job summary

Bluestone is seeking a Care Coordinator to work from home and travel locally in Minnesota to serve MSHO/MSC+ members in communities and assisted living facilities. The role follows standard business hours with travel and remote work components, focusing on proactive, individualized care planning and coordination.

The position emphasizes independent work, strong communication, and collaboration with medical teams to improve outcomes while meeting regulatory and quality standards.

Qualifications

• Active Minnesota RN license or MN Social Worker license.
• Experience with geriatric populations in care settings preferred.
• Valid driver’s license required.

Responsibilities

• Coordinate face-to-face visits with patients and families.
• Manage Elderly Waiver programs and community services.
• Complete annual assessments and PCA assessments.
• Develop individualized care plans based on health needs and goals.
• Collaborate with care teams to meet quality measures and utilization goals.
• Support safe transitions of care and follow-up planning.

Skills

Independence

Verbal communication

Interpersonal skills

Customer service

English proficiency

Problem solving

Education

Minnesota RN license

MN Licensed Social Worker

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 ‑ multidisciplinary care teams collaborate with patients, families and other healthcare providers to deliver preventative, proactive, and tailored care. Using an evidence‑based approach focused on quality care management and data‑driven decisions, Bluestone care teams manage chronic conditions, address social determinants of health, facilitate transitions to and from inpatient settings, provide behavioral health support, and more. Under our model, patients experienced 21% fewer ER visits, 36% fewer hospitalizations, and 41% fewer readmissions compared to similar patients.

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

Position Overview

As a Care Coordinator, you will work from home while traveling locally to serve Minnesota Senior Health Options (MSHO/MSC+) members in the community and assisted living facilities. This full‑time daytime role requires 8 a.m.–5 p.m. Monday–Thursday and 8 a.m.–3 p.m. on Fridays. Travel will be 50–70 % within Ramsey County, including St. Paul, MN, and 30–50 % remote work.

Responsibilities

• Coordinate face‑to‑face visits
• Manage the Elderly Waiver
• Conduct annual assessments, including Personal Care Assistance (PCA) assessments for community members and customized living tools for those in Assisted Living
• Review current health needs, identify goals, and develop individualized care plans
• Connect members with community and state resources and services
• Complete required documentation
• Collaborate with medical care teams to meet health care quality measures and use utilization management tools to achieve value‑based goals
• Support members during transitions of care, ensuring safe discharges and follow‑up plans

Qualifications

Education / Certification / Experience

• Minnesota Registered Nurse license
• OR Current MN Licensed Social Worker (new graduates encouraged)
• One or more years of experience with the geriatric or certified disabled population in case management, home care, group homes, nursing homes, TCU or assisted living settings preferred
• Valid driver’s license

Knowledge / Skills / Abilities

• Ability to work independently
• Private, compliant home office space
• Creative problem‑solving skills
• Appreciation for working with diverse populations
• Strong verbal communication skills
• Excellent interpersonal and customer service skills
• Alignment with Bluestone’s mission and operating philosophies
• Proficiency in reading, writing, speaking, and understanding English

Bluestone Benefits

• Health Insurance
• Dental Insurance
• Vision Materials Insurance
• Company‑paid Life Insurance
• Company‑paid Short and Long‑term Disability
• Health Savings Account (employer contribution)
• Flexible Spending Account (FSA)
• Retirement plan with 4% matching contributions
• Nine paid holidays for office closures and one floating holiday
• Three weeks (15 days) Paid Time Off (PTO)
• Mileage reimbursement program for field employees
• Company‑sponsored cell phone, laptop, and scrubs
• Regular business hours

Pay Transparency: $65,000 – $75,000 USD.