Care Coordinator, RN (MSHO)

B

Bluestone Physician Services

Posted 3 months ago

Full Time

Bloomington, Minnesota

Hybrid

Smart Summary

Responsibilities

Manage member caseloads by coordinating face-to-face visits and conducting annual assessments for MSHO members. Develop individualized care plans and collaborate with medical teams to ensure quality healthcare measures and safe transitions of care.

Qualifications

You have a current Minnesota Registered Nurse license or a MN Licensed Social Worker, with new grads encouraged to apply. You possess 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. A valid driver's license and the ability to travel locally are also required.

Must Have Skills for ATS

Minnesota Registered Nurse license

MN Licensed Social Worker

case management

care coordination

Elderly Waiver

Personal Care Assistance (PCA) assessments

customized living tools

medical care teams

utilization management tools

value-based goals

transitions of care

Job Description

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 Minnesota Registered Nurse license
  • OR MN Licensed Social Worker (new grads encouraged to apply)
  • 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

B

Bluestone Physician Services

Bluestone provides team-based primary care designed for senior living. We bring care directly to our patients and offer services to support their whole health. For 20 years, we’ve been the bridge between families and community staff, helping patients enjoy more days at home and peace of mind. Bluestone also partners with Minnesota health plans by offering Care Coordination that help members understand their benefits, arrange care and remove barriers that stand in the way of better health and independence. Our team members are the heartbeat of our mission: To enrich the lives of those navigating complex health journeys with our compassionate care. By working here, you’ll be part of a team that enriches lives and a culture rooted in trust, collaboration and flexibility.  Bluestone has been named to the Star Tribune's Top Workplaces in Minnesota for the last 13 years in a row! We offer excellent benefits to our team members, including: - Competitive wages - Health Insurance - Dental Insurance - Vision Materials Insurance - Company paid Life Insurance - Company paid Short and Long-term Disability - Health Savings Account (HSA) - Flexible Spending Account (FSA) - Retirement plan with 4% matching contributions - Paid Time Off (PTO) - Nine paid (non-working) holidays - Regular business hours; no evenings or weekends - Mileage reimbursement To find more information about career opportunities, please visit www.bluestonemd.com.
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