Overview
Presbyterian is seeking a Care Coordinator - Albuquerque, NM to facilitate a team approach, including the Interdisciplinary Care Plan team, to ensure appropriate interventions, cost‑effective delivery of quality care and services across the continuum. The role collaborates with the interdisciplinary care plan team which may include members, caregivers, member legal representatives, physicians, 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. The coordinator will manage the care of individual clients with application to identified populations using assessment, care planning, implementation, coordination, monitoring and evaluation for cost‑effective and quality outcomes.
Position details:
Full‑time position – Exempt: Yes
Job is based at Albuquerque, NM
Work hours: Days
Qualifications
Care Coordinator IV
Masters degree & 4 years of experience, Bachelors degree & 8 years of experience, Associates degree & 9 years of experience, 12 years of experience may be utilized in lieu of other education and experience requirements. Must have a valid driver license, clean driving record and be able to travel locally.
Experience in utilization management, quality assurance, home care, community health, long‑term care or occupational health required. 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.
Care Coordinator III
Masters Degree & 2 years experience, Bachelors degree & 4 years experience, Associates degree & 5 years experience, 10 years of experience may be utilized in lieu of other education & experience requirements.
Care Coordinator II
Masters Degree & 1 year experience, Bachelors Degree & 2 years experience, Associates Degree & 3 years experience, 6 years of experience may be utilized in lieu of other education requirements.
Must have a valid driver license, clean driving record, and be able to travel locally.
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.
Responsibilities
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 members, caregivers, member 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.
Conducts in‑depth health risk assessment and/or comprehensive needs assessment which include, but are not limited to, psycho‑social, physical, medical, behavioral, environmental, and financial parameters.
Provides care coordination to members with chronic or complex conditions requiring intensive interventions and oversight, including multiple clinical, social and community resources. Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes.
Develops and communicates plan for authorization of services, and serves as point of contact to ensure services are rendered appropriately, e.g. during transition to home care, backup plans, community‑based services.
Conducts face‑to‑face home visits as required.
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 the plan of care when necessary.
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.
Benefits
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, a growing multi‑specialty medical group, and a workforce of nearly 14,000 employees, making it the largest private employer in the state and 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.
Maximum Offer for this position is up to USD 49.26/Hr.
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.