Care Coordinator, LSW (MSHO)

Bloomington, Minnesota

Bluestone delivers great outcomes by bringing exceptional care to patients living with complex, chronic conditions and disabilities. Our unique, robust model of care goes beyond primary care services — our multidisciplinary care teams collaborate with patients, their families and other healthcare providers to deliver care that is preventative, proactive and tailored to their unique needs.

Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage patients' chronic conditions, address social determinants of health, manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone patients experienced 21% fewer ER visits, 36% fewer hospitalizations and 41% fewer hospital readmissions compared to patients with similar conditions and complexities over the same time period.

Our care teams travel directly to patients who reside in Assisted Living, Memory Care and Group Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our corporate offices in Stillwater, Minnesota, and Tampa, Florida.

Our success is only possible through the hard work of our employees who bring our core values of Dedication, Excellence, Collaboration and Caring to life every day. Bluestone has been named to the Star Tribune's Top Workplace list for the 13th year in a row! Bluestone also achieved Top Workplace USA 2021-2025!

In 2022, Bluestone Accountable Care Organization (ACO) was the best performing ACO in the country as measured by the overall savings per Medicare beneficiary.

Position Overview :

Join our team as a Care Coordinator where you will work with the senior population managing Department of Human Services (DHS) and Center for Medicare/Medicaid Services (CMS) required activities for Minnesota Senior Health Options (MSHO/MSC+) members living in the community and assisted living facilities. In this position, you will work from home, but regularly travel your local area to serve the needs of your members and your community. Schedule: Full time position, day shift hours, no evenings, weekends or holidays. Hours are 8am to 5pm Monday thru Thursday & 8am to 3pm on Fridays. Location: ~50-70% travel mainly throughout the Bloomington and Minneapolis areas and ~30-50% remote work.

Salary Range: $65,000 - $75,000. Salary commensurate with experience.

Responsibilities:

As a Care Coordinator, you will manage member caseloads within your assigned geographic area. This includes:

Coordinating face-to-face visits

Managing the Elderly Waiver

Conducting annual assessments including Personal Care Assistance (PCA) assessments for community members and customized living tools for members residing in Assisted Livings

Reviewing current health needs, identifying goals, and developing individualized care plans

Helping connect members with community and state resources and services

Completing required documentation

Collaborating with medical care teams to ensure health care quality measures are met and use utilization management tools to meet value-based goals

Supporting members during transitions of care as well as collaborating with their care team to ensure a safe discharge and follow up plan

Qualifications:

Education/Certification/Experience

Current MN Licensed Social Worker (new grads encouraged to apply)

OR Minnesota Registered Nurse license

One or more years of experience working with the geriatric or certified disabled population in case management/care coordination, Home Care, Group Homes, Nursing Homes, TCU or Assisted Living settings preferred

Must have a valid driver's license

Knowledge/Skills/Abilities

Ability to work independently

Access to a private and compliant home office space

Creative problem-solving skills

Appreciation for working with diverse populations

Proven ability to communicate effectively with strong verbal skills

Excellent interpersonal and customer service skills

Demonstrated compatibility with Bluestone's mission and operating philosophies

Demonstrated ability to read, write, speak, and understand the English language

Bluestone Benefits:

Health Insurance

Dental Insurance

Vision Materials Insurance

Company paid Life Insurance

Company paid Short and Long-term Disability

Health Savings Account (with employer contribution)

Flexible Spending Account (FSA)

Retirement plan with 4% matching contributions

Nine (9) paid holidays for office closures plus one (1) floating holiday

Three weeks (15 Days) Paid Time Off (PTO)

Mileage reimbursement program for field employees

Company sponsored cell phone, laptop and scrubs

Regular business hours

Pay Transparency $65,000 — $75,000 USD