Care Manager

AmeriHealth Caritas

  • Philadelphia, PA
  • Permanent
  • Full-time
  • 9 days ago
Role OverviewThe Care Manager (RN) provides support tomembers appropriate for care coordination and case management services in achieving their optimal level of health through self-management. The Care Manager (RN) is responsible for engaging the member, member caregiver, and providers to assess, plan, and establish individual member goals.Responsibilities
  • Assess members to determine care coordination and case management needs for all referred members.
  • Completes comprehensive person-centered assessment of physical health, psycho-social health, and environmental health as social determinants of health and supportive needs.
  • Identifies problems/barriers for care coordination and appropriate care management interventions.
  • Coordinates physical, behavioral health, and social services.
  • Provides medication management, including regular medication reconciliation and support of medication adherence.
  • Creates a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health.
  • Identifies both short- and long-term goals and associated time frames for completion. Share goals with the member and caregiver as appropriate.
  • Identifies and implements the appropriate level of intervention based on the member’s needs and clinical progress.
  • Schedules follow-up calls as necessary and makes appropriate referrals. Implements actions to address member issues. Documents progress towards meeting goals and resolving problems.
  • Coordinates care and services.
Education
  • Associate's Degree in Nursing (RN) required
  • Current and unrestricted Registered Nurse licensure in Pennsylvania required
Experience:
  • Minimum of 3 years clinical practice experience in Med/Surg, emergency medicine, home care or behavioral health experience preferred.
  • Minimum of three years of experience as a case manager, preferably providing telephonic case management
  • Eligible to sit for Case Management certification after 12 months of employment. Must obtain this certification after 2 years of employment.
  • Certification as a case manager preferred
  • Proficiency using MS Office (Word, Excel, Outlook), internet applications, and electronic medical record and documentation programs
  • Ability to meet deliverables within designated timeframes; strong organization and communication skills
  • Valid driver’s license with car insurance
Your career starts now. We’re looking for the next generation of healthcare leaders.At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare 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 programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we’d like to hear from you.Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.Discover more about us at www.amerihealthcaritas.com.Our Comprehensive Benefits PackageFlexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.

AmeriHealth Caritas