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Presbyterian Healthcare Services

Presbyterian Healthcare Services is a nonprofit hospital system, health plan, and medical group which provides services for over 660,000 residents of New Mexico

Care Coordinator IV - Raton, NM Area

Location

Colorado

Posted

96 days ago

Salary

$67.1K - $102K / year

Seniority

Mid Level

Job Description

Care Coordinator IV - Raton, NM Area

Presbyterian Healthcare Services

Location Address: Remote Office Denver, CO 80203 Compensation Pay Range: Minimum Offer $67,100.80 Maximum Offer $102,460.80 Summary: Build your Career. Make a Difference. Presbyterian is hiring a skilled Care Coordinator IV. 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 Type of Opportunity: Full time FTE: 1.00 Job Exempt: Yes Work Shift: Days (United States of America) Responsibilities: Presbyterian is seeking a Care Coordinator IV. The Care Coordinator 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. 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: - 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, members 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 not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters. - Provides care coordination to members with chronic or complex conditions which require intensive interventions and oversight include multiple, clinical, social and community resources. Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes. Qualifications: - Masters degree & 4 years of exp, Bachelors degree and 8 yrs of exp, Associates degree and 9 years of exp, 12 years of exp may be utilized in lieu of other education and experience reqs. - 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. 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

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Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 115,000 colleagues serve people in more than 160 countries. JOB DESCRIPTION: Clinical Associate About Abbott Abbott is a global healthcare leader, creating breakthrough science to improve people’s health. We’re always looking towards the future, anticipating changes in medical science and technology. Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and your family, be your true self, and live a full life. You’ll also have access to: - Career development with an international company where you can grow the career you dream of. - Employees can qualify for free medical coverage in our Health Investment Plan (HIP) PPO medical plan in the next calendar year. - An excellent retirement savings plan with a high employer contribution - Tuition reimbursement, the Freedom 2 Save student debt program, and FreeU education benefit - an affordable and convenient path to getting a bachelor’s degree. - A company recognized as a great place to work in dozens of countries worldwide and named one of the most admired companies in the world by Fortune. - A company that is recognized as one of the best big companies to work for as well as the best place to work for diversity, working mothers, female executives, and scientists. The Opportunity Our Abbott story is one of delivering bold solutions in the face of complex healthcare challenges. At Abbott Electrophysiology (EP), we’ve been a leader for over 20 years, pioneering one of the first mapping systems, introducing the first contact force ablation catheter and creating a portfolio of products trusted in millions of procedures around the world. We have and will continue to redefine what’s possible in an evolving and challenging EP landscape. When you join Abbott EP, you become part of a passionate group of individuals who are dedicated to driving the EP space forward and helping people live longer, fuller lives. We are committed to building a foundation for our people to be successful, investing in their development and growth, and creating a diverse, inclusive culture that welcomes different perspectives, experiences and backgrounds. 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United States
$50.7K - $101K / year
Job Closed
OtherRemoteTeam 51-200

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United States
Humana logo

Preauthorization Registered Nurse

Humana

Louisville, Kentucky-based Humana is a leading healthcare company that offers a variety of health, wellness, and insurance products and services designed to off

Become a part of our caring community and help us put health first Are you a transitioning military service member or a military spouse looking for an internship that supports the goal to put health first? The DOW SkillBridge Internship and Military Spouse Fellowship Programs will provide you with key training to perform your internship. You will partner with your team to support members, projects, and to meet goals impacting business outcomes. The professionals you work with at Humana will depend on the type of internship you select. They may include healthcare professionals, HR, and IT, to name a few. The objective is to support and facilitate care for members. To be eligible for this internship, you must either be a transitioning military service member or a military spouse, and you must obtain eligibility to participate in these DOW sponsored programs. The Prior Authorization, Registered Nurse, RN, Intern will report to a manager of the National Medicaid team. 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Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. ​ Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. 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United States + 1 moreAll locations: United States | Trinidad And Tobago
Job Closed

Telephonic Case Manager

Sedgwick

Sedgwick, headquartered in Memphis, Tennessee, provides a global clientele with technology-enabled risk and benefits solutions. Distinguished as an Employer of

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Telephonic Case Manager PRIMARY PURPOSE OF THE ROLE: While partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful return to work through advocacy, communication and coordination of medical services. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work. - Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury. - Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment. - Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting. - Enable our Caring counts® mission supporting injured employees from some of the world’s best brands and organizations. - Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. - Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more. - Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. ESSENTIAL RESPONSIBLITIES MAY INCLUDE - Performs initial and ongoing clinical assessment via telephone calls to evaluate the injured worker's injury, medical treatment, psychosocial needs, cultural implications and support systems. - Effectively communicates and builds relationships with the claims’ examiner, client, injured worker, attorney and supervisor. - Identifies issues related to delayed recovery and/or return to work and problem solves with a creative thinking approach - Negotiates treatment and disability duration with providers through use of medical and disability duration guidelines, adhering to quality. - Identifies opportunities to expedite care for cost containment and timely medical recovery. - Provides recommendations for alternate clinical resources to support claim resolution. - Maintains client's privacy and confidentiality, promotes client safety and advocacy; and adheres to ethical, legal, accreditation and regulatory standards. EDUCATION AND LICENSING Current unrestricted RN license(s) in a state or territory of the United States required. Bachelor's degree in nursing (BSN) from accredited college or university or equivalent work experience preferred. Certification in case management, rehabilitation nursing or a related specialty is highly preferred. ​ TAKING CARE OF YOU BY - Offering a blended work environment. - Supporting meaningful work that promotes critical thinking and problem solving. - Providing on-going learning and professional growth opportunities. - Promoting a strong team environment and a culture of support. - Recognizing your successes and celebrating your achievements. - Thrives when everyone is working towards the same vision/goals. - We offer a diverse and comprehensive benefits package including: - Three Medical, and two dental plans to choose from. - Tuition reimbursement eligible. - 401K plan that matches 50% on every $ you put in up to the first 6% you save. - 4 weeks PTO your first full year. NEXT STEPS If your application is selected to advance to the next round, a recruiter will be in touch. #nurse #telephoniccasemanager As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $73,000 - $75,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Always accepting applications. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

United States
$73K - $75K / year
Job Closed