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Magellan HealthPosted 10/19/2026full-timeRemote • New Mexico • United StatesMid-LevelSenior💰 $50,225 - $75,335 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care coordination, including assessment, care planning, and implementation to enhance member health outcomes. Proficient in utilizing data analysis for quality assurance and effective communication with interdisciplinary teams.
Highest-signal resume keywords
Care CoordinationUtilization ManagementQuality AssuranceData InterpretationEffective Communication
About the role
Key responsibilities & impact- Coordinate care for individual clients through assessment, care planning, implementation, coordination, monitoring, and evaluation
- Perform duties virtually or face-to-face according to contractual requirements
- Promote appropriate use of clinical and financial resources to improve care quality and member satisfaction
- Provide intensive care coordination and oversight for members with behavioral health conditions
- Conduct in-depth health risk and comprehensive needs assessments covering psychosocial, physical, medical, behavioral, environmental, and financial factors
- Communicate and develop care plans and serve as the point of contact for service delivery
- Implement, coordinate, and monitor strategies to improve members' health and quality-of-life outcomes
- Develop, document, and implement plans addressing social, physical, mental, emotional, spiritual, and supportive needs
- Advocate for members by identifying and addressing gaps in care
- Monitor plans of care and measure intervention effectiveness
- Collect clinical path variance data and identify improvement opportunities
- Collaborate with members, families, caregivers, legal representatives, physicians, care providers, ancillary services, and interdisciplinary care teams
- Educate providers, staff, members, and families about care coordination and health strategies
- Facilitate coordinated, cost-effective delivery of quality care across the continuum
- Assist members with questions and concerns regarding care, providers, or delivery systems
- Maintain professional relationships with inpatient, outpatient, community, and other external stakeholders
- Generate reports aligned with care coordination goals
- Assist with orientation and mentoring of new team members as appropriate
Requirements
What you’ll need- Candidate must live in the Albuquerque, NM or surrounding area
- 3-5 years' experience in Social Work, Nursing, Healthcare-related field, or relevant experience in lieu of degree
- Experience in utilization management, quality assurance, home or facility care, community health, long term care, or occupational health
- Experience analyzing trends based on decision support systems
- Business management skills including cost/benefit analysis, negotiation, and cost containment
- Knowledge of referral coordination to community and private/public resources
- Detailed knowledge of cost-effective care coordination and data interpretation
- Ability to make decisions requiring significant analysis and investigation
- Ability to determine courses of action in complex situations not addressed by existing policies or protocols
- Ability to maintain complete and accurate enrollee records
- Effective verbal and written communication skills
- Ability to work with clinicians, hospital officials, and service agency contacts
- GED or high school education required
- Valid in-state driver's license required
- Compliance with security responsibilities, legal, regulatory, contractual, and internal policy requirements
Benefits
Comp & perks- Short-term incentives may be available
- Comprehensive benefits package
- Health, life, voluntary, and other benefits
- Benefits and perks supporting physical, mental, emotional, and financial wellbeing
- Tobacco-free workplace
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
AssessmentCare PlanningHealth Risk AssessmentCost-Benefit AnalysisDecision Support SystemsData AnalysisCare CoordinationMonitoringDocumentationAdvocacy
Soft Skills
Verbal CommunicationWritten CommunicationNegotiationTeam CollaborationMentoring
Certifications & Qualifications
GEDValid In-State Driver's License
Industry Keywords
Behavioral HealthCommunity HealthLong Term CareOccupational HealthHealthcare Coordination