Community Care Case Manager; NM - Albuquerque​/Bernalillo

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time Professional Albuquerque
- Bernalillo County, Albuquerque, NM, US

3 days ago Requisition

Salary Range: $50,000.00 To $60,000.00 Annually

ABOUT ADOBE

Adobe Population Health (APH) is a women-owned health solutions company founded in 2018 with a mission of positively impacting the lives we touch
. Headquartered in Phoenix, AZ, with satellite locations across multiple states, APH fosters a culture rooted in inclusivity, human kindness, and high-quality care.

Recognized by Inc. 5000 as one of America’s Fastest-Growing Private Companies and honored five consecutive years as a “Best Place to Work”
by the
Phoenix Business Journal
, APH continues to expand its reach and impact.

APH partners with health plans, providers, hospitals, and families to deliver tailored programs including case management, in-home and in-clinic wellness assessments, preventative care, transitional care, and social services. As one of the nation’s few fully integrated healthcare organizations, APH delivers comprehensive, coordinated medical and social support through a wide range of specialized service lines.

With continued growth on the horizon, APH is seeking mission-driven individuals who are passionate about improving health outcomes and supporting those in need.

POSITION PURPOSE

As a Population Health Company, we are seeking a Community Care Case Manager to play a pivotal role in coordinating and managing the care of individuals within the community, ensuring they receive comprehensive and integrated services. This position requires a skilled and compassionate professional who can assess clients' needs, develop care plans, and collaborate with various healthcare and social service providers.

The Community Care Case Manager advocates for clients promotes their well-being and facilitates access to resources that support health and independence.

As a Community Care Case Manager, you will play a critical role in improving the health outcomes and quality of life for individuals within the community. Their comprehensive and client-centered approach helps bridge gaps in care, promotes wellness, and empowers clients to achieve their health goals.

This role reports to our Community Care Area Manager.

This position is based in the field and requires travel throughout Albuquerque, Bernalillo County, and surrounding areas to support members.

DUTIES & RESPONSIBILITIES

• Care Coordination Compliance:
  Ensure care coordination complies with 42 C.F.R. § 438.208 and all relevant agreement requirements.
• Health Risk Assessment:
  Perform standardized Health Risk Assessments (HRAs) as per New Mexico Health Services Department guidelines, determining if members need comprehensive assessments.
• Member Classification:
  Accurately place each member in appropriate care coordination levels as per agreement standards.
• Comprehensive Needs Assessment (CNA):
  Conduct CNAs for members meeting specific conditions, complete related questionnaires, and agreements, and inform members about community benefits tailored to their needs.
• Care Plan Development:
  Develop and implement Comprehensive Care Plans (CCPs) based on individual member needs and preferences in alignment with the agreement guidelines.
• Ongoing Care Delivery:
  Deliver continuous care coordination services in accordance with the member’s assessed needs, CCP, and required frequency of contact.
• Response to Member Needs:
  Consistently assess and respond to members' needs for services and assistance.
• Level 2 and 3 Coordination:
  Conduct CNAs for members meeting specified indicators to determine…