Care Manager (San Juan, McKinley County based)- LPN/RN

Job description

Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. This role works in the San Juan or McKinley Counties. Essential Job Duties: - Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments. - Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. - Conducts telephonic, face-to-face or home visits as required. - Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. - Maintains ongoing member caseload for regular outreach and management. - Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home...