Magellan Health
Care Coordinator- CISC
Magellan Health
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. Duties are typically performed during face‑to‑face home visits. Promotes the appropriate use of clinical and financial resources to improve the quality of care and member satisfaction. Assists with orientation and mentoring of new team members as appropriate.
Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple clinical, social and community resources.
Conducts in‑depth health risk assessment and/or comprehensive needs assessment which includes psycho‑social, physical, medical, behavioral, environmental and financial parameters.
Communicates and develops the care plan and serves as point of contact to ensure services are rendered appropriately, e.g., during transition to home care, backup plans, community‑based services.
Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.
Develops, documents and implements a plan that 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 member’s care plan.
Assesses and reviews plan of care regularly to identify gaps in care and 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.
Educates providers, supporting staff, members and families regarding the care coordination role and health strategies with a focus on a member‑focused approach to care.
Facilitates a team approach to the coordination and cost‑effective delivery of quality care and services.
Collaborates with the interdisciplinary care plan team to address care issues and specific member needs and disease processes including medical, behavioral, social, community‑based or long‑term care services.
Provides assistance to members with questions and concerns regarding care, providers or the delivery system.
Maintains professional relationships with external stakeholders such as inpatient, outpatient and community resources.
Generates reports in accordance with care coordination goals.
Job Requirements
3‑5 years experience in Social Work, Nursing, or a healthcare‑related field, or relevant experience in lieu of a degree.
Experience in utilization management, quality assurance, home or facility care, community health, long‑term care or occupational health.
Experience in analyzing trends based on decision‑support systems.
Business‑management skills incl. cost/benefit analysis, negotiation and cost containment.
Knowledge of referral coordination to community and private/public resources.
Detailed knowledge of cost‑effective coordination of care and data interpretation.
Ability to make decisions that require significant analysis, investigation and original thinking.
Ability to determine appropriate actions in complex situations not addressed by existing policies or protocols.
Decisions include staffing changes, order of work, and application of established procedures.
Ability to maintain complete and accurate enrollee records.
Effective verbal and written communication skills. Ability to work well with clinicians, hospital officials and service‑agency contacts.
General Job Information Title:
Care Coordinator- CISC
Grade:
22
Work Experience – Required:
Clinical, Quality
Work Experience – Preferred:
(none listed)
Education – Required:
GED, High School
Education – Preferred:
Associate, Bachelor’s
License and Certifications – Required:
Driver License, Valid In‑State
License and Certifications – Preferred:
CCM – Certified Case Manager; LCSW – Licensed Clinical Social Worker; RN – Registered Nurse, State or Compact Licensure
Salary Range:
$50,225 - $75,335
This position may be eligible for short‑term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco‑free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position and comply with all applicable legal, regulatory, contractual, internal policy and procedural requirements.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Other
Industry Hospitals and Health Care
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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. Duties are typically performed during face‑to‑face home visits. Promotes the appropriate use of clinical and financial resources to improve the quality of care and member satisfaction. Assists with orientation and mentoring of new team members as appropriate.
Provides care coordination to members with behavioral health conditions identified and assessed as requiring intensive interventions and oversight including multiple clinical, social and community resources.
Conducts in‑depth health risk assessment and/or comprehensive needs assessment which includes psycho‑social, physical, medical, behavioral, environmental and financial parameters.
Communicates and develops the care plan and serves as point of contact to ensure services are rendered appropriately, e.g., during transition to home care, backup plans, community‑based services.
Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.
Develops, documents and implements a plan that 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 member’s care plan.
Assesses and reviews plan of care regularly to identify gaps in care and 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.
Educates providers, supporting staff, members and families regarding the care coordination role and health strategies with a focus on a member‑focused approach to care.
Facilitates a team approach to the coordination and cost‑effective delivery of quality care and services.
Collaborates with the interdisciplinary care plan team to address care issues and specific member needs and disease processes including medical, behavioral, social, community‑based or long‑term care services.
Provides assistance to members with questions and concerns regarding care, providers or the delivery system.
Maintains professional relationships with external stakeholders such as inpatient, outpatient and community resources.
Generates reports in accordance with care coordination goals.
Job Requirements
3‑5 years experience in Social Work, Nursing, or a healthcare‑related field, or relevant experience in lieu of a degree.
Experience in utilization management, quality assurance, home or facility care, community health, long‑term care or occupational health.
Experience in analyzing trends based on decision‑support systems.
Business‑management skills incl. cost/benefit analysis, negotiation and cost containment.
Knowledge of referral coordination to community and private/public resources.
Detailed knowledge of cost‑effective coordination of care and data interpretation.
Ability to make decisions that require significant analysis, investigation and original thinking.
Ability to determine appropriate actions in complex situations not addressed by existing policies or protocols.
Decisions include staffing changes, order of work, and application of established procedures.
Ability to maintain complete and accurate enrollee records.
Effective verbal and written communication skills. Ability to work well with clinicians, hospital officials and service‑agency contacts.
General Job Information Title:
Care Coordinator- CISC
Grade:
22
Work Experience – Required:
Clinical, Quality
Work Experience – Preferred:
(none listed)
Education – Required:
GED, High School
Education – Preferred:
Associate, Bachelor’s
License and Certifications – Required:
Driver License, Valid In‑State
License and Certifications – Preferred:
CCM – Certified Case Manager; LCSW – Licensed Clinical Social Worker; RN – Registered Nurse, State or Compact Licensure
Salary Range:
$50,225 - $75,335
This position may be eligible for short‑term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco‑free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position and comply with all applicable legal, regulatory, contractual, internal policy and procedural requirements.
Seniority Level Mid‑Senior level
Employment Type Full‑time
Job Function Other
Industry Hospitals and Health Care
#J-18808-Ljbffr