Care Manager (Remote) Albuquerque, NM

Acting as a Care Manager supporting our NM Medicaid members to ensure management of health conditions. This is a combination of phone call outreach and in-person meetings with members.

Responsibilities

• Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments.
• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face, or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support, and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• Collaborates with licensed care managers/leadership as needed or required.
• 25-40% estimated local travel may be required (based upon state/contractual requirements). Mileage is reimbursed.

Requirements

• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates.
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job-related travel requirements, unless otherwise required by law.
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed—working with diverse populations, various personalities, and personal situations.
• Ability to work independently, with minimal supervision, and self-motivation.
• Ability to demonstrate responsiveness in all forms of communication and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
• Excellent problem-solving and critical-thinking skills.
• Strong verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

Schedule

• Monday through Friday, 8 AM to 5 PM Mountain Time (no weekends, no nights, no holidays).
• Alternative work schedules available after 6 months of experience: four 10-hour shifts or four 9-hour shifts and a half-day shift.

Pay

Pay Range: $24 - $46.81 per hour. Actual compensation may vary based on geographic location, work experience, education, and/or skill level.