Care Coordinator II-Albuquerque

Location: 9521 San Mateo NE, Albuquerque, NM 87113-2237

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 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—including more than 1,600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care), and Commercial health plans.

Pay

Pay Range Minimum Offer: $27.52
Maximum Offer: $46.86

Benefits

• 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
• Shift 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
• 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

Responsibilities

• 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 the member, caregivers, member’s legal representative, physician, care providers, and ancillary support services—to address care issues, specific member needs, and disease processes (medical, behavioral, social, community-based, or long-term care services).
• Conducts in-depth health risk assessments and/or comprehensive needs assessments, including but not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters.
• Provides care coordination to members with chronic or complex conditions requiring intensive interventions and oversight, including 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 plans for authorization of services, serving as the point of contact to ensure services are rendered appropriately (e.g., during transitions to home care, backup plans, community-based services).
• Conducts face-to-face home visits, as required.
• Assesses and reviews the plan of care regularly to identify gaps in care and trends to improve health and quality of life outcomes.
• Collects clinical path variance data to indicate potential areas for improvement of case and services provided; works with members and the interdisciplinary care plan team to adjust the plan of care when necessary.

Requirements

• Master’s Degree & 1 year of experience, or Bachelor’s Degree & 2 years of experience, or Associate’s Degree & 3 years of experience, or 6 years of experience (may be utilized in lieu of other education requirements).
• Must have a valid driver’s license, clean driving record, and ability to travel locally.
• Business management skills, including but not limited to cost/benefit analysis, negotiation, and cost containment.
• Knowledge of referral coordination to community and private/public resources.

Schedule

Full-time (1.00 FTE), Day Shift