Care Coordinator, RN (MSHO)

The Blue Venture Fund; Saint Paul (MN); On-site; USD 65,000 - 75,000; Full time

Benefits offered by this job

Health Insurance

HSA with employer contribution

Flexible Spending Account (FSA)

Retirement plan with 4% matching

Mileage reimbursement

Company sponsored cell phone, laptop,+

Paid holidays

Job summary

Bluestone Physician Services is seeking a Care Coordinator to support Minnesota Senior Health Options (MSHO/MSC+) members in community and assisted living settings. This role is remote with regular local travel, scheduling 8am–5pm Mon–Thu and 8am–3pm Fri.

Responsibilities include coordinating visits, assessing needs, creating care plans, and linking members to state resources. RN or MSW credentials encouraged; valid driver's license required.

Qualifications

• Must hold Minnesota RN license or MN Licensed Social Worker.
• Experience in geriatric or disabled population preferred.
• Valid driver’s license required.

Responsibilities

• Coordinating face-to-face visits.
• Managing the Elderly Waiver.
• Conducting annual PCA assessments for community members.
• Developing individualized care plans.
• Connecting members with community resources and services.
• Completing required documentation.
• Collaborating with care teams to meet quality measures and utilization goals.
• Supporting transitions of care and safe discharge planning.

Skills

Independent work

Verbal communication

Customer service

Education

MN RN license

MN Licensed Social Worker (LMSW)

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 Ramsey County, including St. Paul, MN areas 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 Living
• 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

• Minnesota Registered Nurse license
• OR Current MN Licensed Social Worker (new grads encouraged to apply)
• 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

• Ability to work independently
• Access to a private and compliant home office space
• Creative problem-solving skills
• Appreciation for working with diverse populations
• Proven ability to communicate effectively with strong verbal skills
• Excellent interpersonal and customer service skills
• Demonstrated compatibility with Bluestone’s mission and operating philosophies
• Demonstrated ability to read, write, speak, and understand the English language

Benefits

• Health Insurance
• Company paid Short and Long-term Disability
• Health Savings Account (with employer contribution)
• Flexible Spending Account (FSA)
• Retirement plan with 4% matching contributions
• Nine (9) paid holidays for office closures plus one (1) floating holiday
• Mileage reimbursement program for field employees
• Company sponsored cell phone, laptop and scrubs
• Regular business hours

Pay Transparency: $65,000 - $75,000 USD

As set forth in Bluestone Physician Services’s Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law.