Job type full-time
Full job description
The care manager will support members for the coordination of their health needsCandidates should be a nh registered nurse or social workerThis is a full time remote role.
Your career starts nowWe’re looking for the next generation of health care leaders.
At amerihealth caritas, we’re passionate about helping people get care, stay well and build healthy communitiesAs one of the nation`s leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programsAmerihealth caritas is seeking talented, passionate individuals to join our teamTogether we can build healthier communitiesIf you want to make a difference, we’d like to hear from you.
Headquartered in philadelphia, amerihealth caritas is a mission-driven organization with more than 30 years of experienceWe deliver comprehensive, outcomes-driven care to those who need it mostWe offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative servicesDiscover more about us at www.amerihealthcaritas.com.
The care manager (rn/sw) assists members appropriate for care coordination and case management services in achieving their optimal level of healthThe care manager (rn/sw) is responsible for engaging the member and providers to assess, plan and establish individual member goalsWill facilitate and coordinate care for the members while assuring quality and use of cost-effective resourcesThe position will function as a single point of contact and be an advocate for members in the care coordination programAssess members to determine care coordination and case management needs for all referred membersCompletes comprehensive assessment of environmental, psycho-social and support needsIdentifies problems/barriers for care coordination and appropriate care management interventionsCreates a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of healthIdentifies both short and long term goals and associated time frames for completionShares goals with the member and family as appropriateIdentifies and implements the appropriate level of intervention based upon the member’s needs and clinical progressSchedules follow up calls as necessary, makes appropriate referralsImplements actions to address member issuesDocuments progress towards meeting goals and resolving problemsCoordinates care and services with the account manager, complex rn case manager, and member, family members as appropriate, pcp, specialist, and facility/vendor providers.
A bachelors (or higher) degree in a health related field and licensure as a health professional (where such licensure is available); or certification as a case manager (as documented and accepted on urac’s website@ www.urac.org); or msw licensure and three (3) years professional practice experience; and active state rn license.
Valid driver’s license with car insurance.
Current unrestricted social worker license.
3 to 5 years of case management preferred.