Care Management Coordinator

Job Title: Member Care Coordinator

Location: Farmington/Gallup, NM

Contract Duration: 6 months - Contract to hire

Job Description:

The Member Care Coordinator is responsible for conducting home health assessments and engaging members to support their individual healthcare needs and personal health plans. This role involves educating members about available healthcare programs, performing outreach and follow-ups, and assisting the clinical team within the Medical Management department. The coordinator works closely with members to encourage adherence to care plans, respond to inquiries, coordinate services, and ensure accurate documentation in the system.

Key Responsibilities:

• Conduct home health assessments and update member information in the system.
• Perform outreach and follow-ups with members regarding their healthcare plans.
• Educate members about healthcare programs and encourage participation in care management services.
• Coordinate member services such as appointments, transportation, and other support services.
• Conduct regular check-ins with members to review and support care plan goals.
• Provide non-clinical support to clinicians to help manage and close cases in the system.
• Respond to member and provider inquiries through phone, email, or written communication.
• Perform research, gather medical records or necessary documentation, and maintain accurate data entry.
• Collaborate with internal teams such as Marketing, Provider Affairs, and other departments.
• Ensure compliance with HIPAA policies and maintain confidentiality of member information.

Qualifications:

• Bachelor’s degree in Social Work or Psychology OR RN OR LVN/LPN with 1 year of managed care experience OR 3 years of care coordination experience in a managed care or waiver program.
• Knowledge of medical terminology.
• Experience coordinating member healthcare needs and assisting members with services.
• Strong customer service and communication skills.
• Proficiency with Microsoft Office and computer systems.
• Ability to educate members and support care plan adherence.
• Valid driver’s license, reliable transportation, and willingness to travel.