Care Coordinator IV
 Presbyterian Healthcare Services | |
 United States, New Mexico, Albuquerque | |
| 1100 Central Avenue Southeast (Show on map) | |
 Dec 23, 2025 | |
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Location Address: 9521 San Mateo NE , Albuquerque, New Mexico 87113-2237, United States of AmericaCompensation Pay Range: Minimum Offer $: 67100.8Maximum Offer for this position is up to $: 102460.8Summary: Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across thecontinuum. 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 Sign onandrelocation bonusesavailable for qualified candidates. Type of Opportunity: Full timeFTE: 1Job Exempt: YesWork Shift: Days (United States of America)Job Description: *Supports Health plan members*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, documents and implements plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for members care needs by identifying and addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the members care plan. *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. *Educates providers, support staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services. *Provides assistance to members with questions and concerns regarding care, providers or delivery system. *Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources. *Complies with Case Management Society of America Standards for Case Management Practice and with CCMC code of Professional Conduct for Case Managers. *Participates in Interdisciplinary Care Team (ICPT) meetings. *May assist with orientation and continued mentoring of team members as appropriate. *Performs other functions as required. Qualifications: 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. UPDATED: 10/11/24 We're all about well-being, starting with yours. | |