Location Address:

Compensation Pay Range:

Summary:

How you grow, learn and thrive matters here.
• 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)
• 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

Responsibilities:

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.

Some key responsibilities include

• Supports Health plan members
• 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 communicate 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.

Qualifications:

• HS Diploma & 3 years experience.
• 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.

We're all about well-being, starting with yours.
Presbyterian employees have 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 and more.

Learn more about our employee benefits.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are 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 1600 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.

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

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.

We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services