Care Coordinator IV-Complete Care Program

$65,146 - $99,486/Yr

Presbyterian Healthcare Services - Albuquerque, NM

Full-time - Senior

Albuquerque, NM

10,001+ employees

Ambulatory Health Care Services

About the position

The Care Coordinator IV-Complete Care Program is responsible for facilitating a team approach to ensure appropriate interventions and cost-effective delivery of quality care across various services. This role involves collaboration with an interdisciplinary care plan team to address care issues and specific member needs, focusing on medical, behavioral, social, and community-based services. The coordinator will assess, plan, implement, and monitor care for individual clients, ensuring quality outcomes and effective resource utilization.

Responsibilities

• Supports patients in a hospital/inpatient or clinic setting.
• Facilitates a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions and cost-effective delivery of quality care.
• Collaborates with the Interdisciplinary Care Plan Team to address care issues and specific member needs.
• Conducts in-depth health risk assessments and comprehensive needs assessments.
• Provides care coordination to members with chronic or complex conditions requiring intensive interventions.
• Implements, coordinates, and monitors strategies for members and families to improve health outcomes.
• Develops, documents, and implements plans to address social, physical, mental, emotional, 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 plans for authorization of services and serves as the point of contact for service delivery.
• Conducts face-to-face home visits as required.
• Assesses and reviews plans of care regularly to identify gaps and trends for improvement.
• Promotes appropriate use of clinical and financial resources to improve quality of care and member satisfaction.
• Generates reports in accordance with care coordination goals.
• Educates providers, support staff, members, and families regarding care coordination roles and health strategies.
• Maintains professional relationships with external stakeholders.
• Participates in Interdisciplinary Care Team meetings.
• May assist with orientation and mentoring of team members.

Requirements

• Bachelor's Degree and 6 years of related experience, or 6 years of additional experience in lieu of a Bachelor's degree.
• Master's degree and 4 years of experience preferred.
• Valid driver license with a clean driving record and ability 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 including cost/benefit analysis, negotiation, and cost containment.
• Knowledge of referral coordination to community and private/public resources.

Nice-to-haves

• Experience in travel nursing.
• Pharmacy Technician Certification.

Benefits

• Wellness program
• Disability insurance
• Health insurance
• Dental insurance
• Paid time off
• Vision insurance
• Life insurance