Care Coordinator, Eddy County, Lea County, Chaves County
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Job Description
Care Coordinator coordinating intensive behavioral health services and resources for Magellan Health members. Conducting assessments, care plans, monitoring, and interdisciplinary collaboration across New Mexico counties.
Responsibilities:
- Coordinate care for individual clients and identified populations through assessment, care planning, implementation, coordination, monitoring, and evaluation
- Perform duties virtually or face-to-face based on contractual requirements
- Promote appropriate use of clinical and financial resources to improve quality of care and member satisfaction
- Assist with orientation and mentoring of new team members as appropriate
- Provide care coordination to members with behavioral health conditions requiring intensive interventions and oversight
- Conduct in-depth health risk and comprehensive needs assessments covering psychosocial, physical, medical, behavioral, environmental, and financial parameters
- Communicate and develop care plans and serve as point of contact to ensure services are rendered appropriately
- Implement, coordinate, and monitor strategies to improve members' and families' health and quality-of-life outcomes
- Develop, document, and implement plans addressing social, physical, mental, emotional, spiritual, and supportive needs
- Advocate for members by identifying and addressing gaps in care
- Monitor plans of care and measure intervention effectiveness
- Review plans regularly to identify care gaps and trends
- Collect clinical path variance data to identify improvement opportunities
- Work with members and interdisciplinary care plan teams to adjust plans of care
- Educate providers, staff, members, and families regarding care coordination and health strategies
- Facilitate team-based, cost-effective delivery of quality care and services
- Collaborate with members, caregivers, legal representatives, physicians, care providers, and ancillary support services
- Assist members with questions and concerns regarding care, providers, and delivery systems
- Maintain professional relationships with inpatient, outpatient, and community stakeholders
- Generate reports according to care coordination goals
- Comply with position-specific security responsibilities, legal, regulatory, contractual, and internal policy requirements
Requirements:
- 3–5 years' experience in Social Work, Nursing, Healthcare-related field, or relevant experience in lieu of degree
- Experience in utilization management, quality assurance, home or facility care, community health, long-term care, or occupational health
- Experience analyzing trends based on decision support systems
- Business management skills, including cost/benefit analysis, negotiation, and cost containment
- Knowledge of referral coordination to community and private/public resources
- Detailed knowledge of cost-effective care coordination and data interpretation
- Ability to make decisions requiring significant analysis and investigation
- Ability to determine courses of action in complex situations not addressed by existing policies or protocols
- Ability to maintain complete and accurate enrollee records
- Effective verbal and written communication skills
- Ability to work with clinicians, hospital officials, and service agency contacts
- GED or high school education required
- Valid in-state driver's license required
- CCM, LCSW, or RN certification/licensure preferred
Benefits:
- Short-term incentives may be available
- Comprehensive benefits package
- Health, life, voluntary and other benefits
- Benefits and perks supporting physical, mental, emotional and financial wellbeing
- Tobacco-free workplace
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