Care Coordinator II - Operational Improvement

Type of Opportunity: Per Required Need
FTE: 0.001000
Exempt: Yes
Work Schedule: Days

The Care Coordinator II 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. This position also 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

Type of Opportunity: Full Time
FTE: 1.000000
Exempt: Yes
Work Schedule: Days

We're all about well-being, starting with yours.

Presbyterian employees have access to a fun, engaging and unique program including free, on-site and community based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more. Presbyterian is committed to an inclusive and equitable environment where everyone is valued and empowered for success. We believe our environment should reflect the diversity of our community.

How you grow, learn and thrive matters here.

Educational and career development options, including tuition and certification reimbursement, scholarship opportunities.
• Strongline staff safety (a wearable badge that allows employees to quickly and discreetly call for help when safety is a concern).
• Shift differentials for nights and weekends
• Differentials for higher education, certifications and various lead roles
• Malpractice liability insurance

• Requires a minimum of an Associates Degree and 2 years of related experience. 3 years of additional experience can be substituted in lieu of an Associates Degree. Bachelors degree 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 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.
• 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.

• Supports patients in a hospital/inpatient or clinic setting
• 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.
• Provides care coordination to members with chronic condition with less complex needs including less community resources. 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. 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).
• 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.
• 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 member s 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.
• Provides assistance to members with questions and concerns regarding care, providers or delivery system.
• Conducts face to face home visits, as required.
• Educates providers, support staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services.
• Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.
• 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.
• Participates in Interdisciplinary Care Team (ICPT) meetings.
• Assists with orientation and mentoring of new team members as appropriate.
• Performs other functions as required.

We offer more than the standard benefits!

Learn more about our employee benefits:

https://www.phs.org/careers/why-work-with-us/benefits

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 comprised of nin 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 13,000 employees, including over 1,200 providers and nearly 3,500 nurses.

Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial Health Plans.

About Lincoln County Medical Center

Nestled between tall pines and mountain vistas at an elevation of 6,900 feet, Ruidoso is a mountain oasis in southern New Mexico. With a population of nearly 20,000, Lincoln County offers many larger-town amenities in a smaller-community environment, including a wide range of activities from outdoor adventures to art galleries and theaters.

Ruidoso is home to Presbyterian's Lincoln County Medical Center which has served the Ruidoso and Lincoln County community since 1950 when the facility first opened as the Ruidoso-Hondo Valley General Hospital. Lincoln County Medical Center is owned by the County of Lincoln, and, since 1972, Lincoln County Medical Center has been leased and managed by Presbyterian Healthcare Services, greatly aiding in its growth and advancement. Learn more about Ruidoso here.

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