Care Coordinator IV - job 1 of 4

Overview

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, member s 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

 

We're determined to take care of those working in healthcare.

Presbyterian is dedicated to improving people's lives - the lives of our patients and the lives of our coworkers. We're a locally owned and operated, which encourages supportive leadership that empowers employees. And we provide the opportunity to grow from entry-level to the most senior positions.

Why Join Us

• Full Time - Exempt: Yes
• Job is based at Albuquerque, NM
• Remote work from home: this job is intended to be conducting in the state of New Mexico.
• Work hours: Weekday Schedule Monday-Friday
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

 

Ideal Candidate:

• Must have a valid driver license, clean driving record and able to travel locally.
• Experience in utilization management,  home care, community health, long term care or occupational health 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.
• 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.

Responsibilities

• 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, andancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term careservices.
• 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 communityresources. 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 homecare, 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 indicatespotential 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.

Benefits

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian? As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services Presbyterian exists to ensure the patients, members and communities we serve can achieve their best health. We are a locally owned, not-for-profit healthcare system 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 14,000 employees.

Our health plan serves more than 580,000 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.

Maximum Offer for this position is up to

USD $49.26/Hr.

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.