Care Coordinator - Health Plan

Location Address:

Compensation Pay Range:

Minimum Offer $:

Maximum Offer for this position is up to $:

Summary:

Sign onandrelocation bonusesavailable for qualified candidates.

How you grow, learn and thrive matters here.
* Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
* Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
* Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
* Malpractice liability insurance
* Loan forgiveness through the New Mexico Higher Education Department
* EPIC electronic charting system

Type of Opportunity:

FTE:

Job Exempt:

Work Shift:

Job Description:

Presbyterian is seeking a Care Coordinator - Gallup/Grants, NM

Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates with the interdisciplinary care plan team which may include member, caregivers, members legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. 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

Some key responsibilities include

• Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the
  continuum. Collaborates with the Interdisciplinary Care Plan Team which may include member, caregivers, members legal representative, physician, care providers, and
  ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care
  services.
• Conducts in depth health risk assessment and/or comprehensive needs assessment which include, but not limited to psycho-social, physical, medical, behavioral,
  environmental, and financial parameters.
• Provides care coordination to members with chronic or complex conditions which require intensive interventions and oversight include multiple, clinical, social and community
  resources. Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.
• Develops and communicates plan for authorization of services, and serves as point of contact to ensure services are rendered appropriately, (i.e. during transition to home
  care, back up plans, community based services).
• Conducts face to face home visits, as required,
• Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; collects clinical path variance data that indicates
  potential areas for improvement of case and services provided; works with members and the interdisciplinary care plan team to adjust plan of care, when necessary.
• Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Generates reports in accordance with care coordination goals.

Qualifications:

Care Coordinator IV

• Masters degree & 4 years of exp, Bachelors degree and 8 yrs of exp, Associates degree and 9 years of exp, 12 years of exp may be utilized in lieu of other education and experience reqs. Must have a valid driver license, clean driving record and able to travel locally.
• Experience in utilization management, quality assurance, home care, community health, long term care or occupational health required. Proficiency in Microsoft Word, Excel and Outlook required.
• Experience in analyzing trends based on decision support systems. Business management skills to include, but not limited to, cost/benefit analysis,negotiation, and cost containment. Knowledge of referral coordination to community & private/public resources.

Care Coordinator III

• Masters Degree & 2 years exp, Bachelors degree & 4 years exp, Associates degree & 5 years exp, 10 years of exp may be utilized in lieu of other education & exp reqs.

Care Coordinator II

• Masters Degree & 1 years exp, Bachelors Degree & 2 years exp, Associates Degree & 3 years exp, 6 years of exp may be utilized in lieu of other education reqs.
• Must have a valid driver license, clean driving record, and able to travel locally.
• Business management skills to include, but not limited to, cost/benefit analysis, negotiation, and cost containment.
• Knowledge of referral coordination to community & private/public resources.

We're all about well-being, starting with yours.
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.

Learn more about our employee benefits.

Presbyterian is committed to an inclusive and equitable environment where everyone is valued and empowered for success. We believe that our environment should reflect the diversity of our community.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses.
Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.