Care Coordinator I-Community Health Worker

Presbyterian is seeking a compassionate and skilled Care Coordinator I-Community Health Worker

Participant of the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. 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.

Full Time - Exempt: Yes
• Job is based Albuquerque
• Work hours: Days

Ideal Candidate:

• Experience in utilization management, quality assurance, home care, community health, long term care or occupational health required. CCM certification preferred or must obtain within 3 years of hire.
• Proficiency in Microsoft Word, Excel and Outlook required. Experience in analyzing trends based on decision support systems.

• High School diploma or equivalent and 2+ years relevant work experience in the healthcare field required; managed care experience preferred.
• 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, medical assistant or occupational health required.
• Proficiency in Microsoft Word, Excel and Outlook required.
• 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.

• Participant of the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. 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.
• Provides care coordination to members with stable chronic condition and /r with those whose care requires coordination for some period of time. 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 health risk assessment and/or comprehensive needs assessment which includes, but is not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters under the supervision of a licensed professional.
• 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. Duties performed under the supervision of a licensed professional.
• Conducts face to face home visits, as required.
• Facilitates a team approach to the coordination and cost effective delivery to quality care and services. Educates providers, support staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care.
• 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.
• Assists with orientation and mentoring of new team members as appropriate.
• Performs other functions as required.

About Presbyterian Healthcare Services

Presbyterian offers a comprehensive benefits package to eligible employees, including medical, dental, vision, disability coverage, life insurance, and optional voluntary benefits.

The Employee Wellness Rewards Program encourages staff to engage in health-enhancing activities-like challenges, webinars, and screenings-with opportunities to earn gift cards and other incentives.

As a mission-driven organization, Presbyterian is deeply committed to improving community health across New Mexico through initiatives like growers' markets and local partnerships.

Founded in 1908, Presbyterian is a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group. With nearly 14,000 employees, it is the largest private employer in the state, serving over 580,000 health plan members through Medicare Advantage, Medicaid, and Commercial plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.