Hybrid Care Coordinator, LSW – MSHO for Seniors

Bluestone Physician Services; Winona (MN); Hybrid; USD 65,000 - 75,000; Full time

Benefits offered by this job

Health Insurance

Disability Insurance

Health Savings Account

Flexible Spending Account

Retirement plan with 4% matching

9 paid holidays

Mileage reimbursement

Cell phone & scrubs provided

Regular business hours

Job summary

Bluestone Physician Services in Minnesota seeks a Care Coordinator to empower seniors by managing DHS and CMS requirements for MSHO/MSC+ members. This hybrid role combines home visits with local travel in Winona County and remote work from home.

You will coordinate face-to-face visits, assess needs, develop care plans, link to community resources, and support transitions of care. The role requires MN licensed social worker or RN, driver’s license, and 1+ year geriatric care coordination

Qualifications

• Current MN Licensed Social Worker (LSW, LMSW, LISW, or LICSW) - New grads encouraged to apply.
• MN Registered Nurse license required.
• One or more years of geriatric or disabled population experience 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

• Coordinate face-to-face visits.
• Manage the Elderly Waiver.
• Conduct annual PCA assessments and develop living tools for community members.
• Review health needs, set goals, and develop individualized care plans.
• Connect members with community and state resources and services.
• Help members remain safely in their homes and communities.
• Complete required documentation.
• Collaborate with care teams to meet quality measures and value-based goals.
• Support transitions of care and safe discharges.

Skills

Independence

Problem-solving

Diversity-friendly

Verbal communication

Customer service

English proficiency

Education

MN Licensed Social Worker (LSW/LMSW/LISW/LICSW)

Minnesota Registered Nurse license

Job description

Bluestone Physician Services in Minnesota seeks a Care Coordinator to empower seniors by managing DHS and CMS requirements for MSHO/MSC+ members. This hybrid role combines home visits with local travel in Winona County and remote work from home.

You will coordinate face-to-face visits, assess needs, develop care plans, link to community resources, and support transitions of care. The role requires MN licensed social worker or RN, driver’s license, and 1+ year geriatric care coordination