Care Manager II

AmeriHealth Caritas; Burlington (NC); On-site; USD 60,000 - 80,000; Full time

Job summary

AmeriHealth Caritas is seeking a Care Manager (RN/LCSW) to assist members in achieving optimal health through self-management and care coordination. The successful candidate will assess member needs, create care plans, and coordinate with healthcare providers to ensure quality care. This role includes responsibilities for medication management and transitional care management, making a significant impact on community health.

Benefits

Flexible work options

401(k)

Tuition reimbursement

Health insurance from Day 1

Competitive pay

Paid time off

Qualifications

• At least 3 years of professional practice experience.
• Active state Clinical Social Work license.
• 3 to 5 years of Case/Care Management experience preferred.

Responsibilities

• Assess members to determine care coordination and management needs.
• Create a care plan to help members achieve their health goals.
• Coordinate care with other healthcare providers.

Skills

Care Coordination

Communication

Assessment

Problem Solving

Education

Master’s Degree in Social Work

Registered Nurse (RN)

Job description

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, Pennsylvania, 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.

Responsibilities:

The Care Manager (RN/LCSW) assists members appropriate for care management and care coordination services in achieving their optimal level of health through self-management. The Care Manager (RN/LCSW) is responsible for engaging the member, member care giver, and providers to assess, plan, and establish individual member goals. Will facilitate and coordinate care for the members while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for members in the care management program. Additionally, the Care Manager will oversee these care management activities within assigned AMH Tier III/CIN practices to ensure high-quality services in accordance with Plan, NCQA, Federal/State standards and requirements.

• Assess members through face-to-face encounters or by telephone to determine care coordination and management needs.
• Complete comprehensive person-centered assessments including physical health history, mental health history, social determinants of health, and supportive needs.
• Coordinate physical, behavioral health, and social services.
• Provide medication management, including medication reconciliation and support for adherence.
• Identify problems and barriers for care and implement appropriate interventions.
• Create a care plan to help members reduce or resolve issues and barriers to achieve their health goals.
• Identify goals, set priorities, and establish time frames for achievement, sharing these with the member and family as appropriate.
• Implement interventions based on the member’s needs and progress.
• Schedule follow-up calls, make referrals, document progress, and address member issues.
• Coordinate care with other healthcare providers and team members.
• Provide transitional care management.
• Participate in scheduled meetings with the AMH/CIN, including JOC meetings.

Education/Experience:

• Master’s Degree in Social Work (SW).
• Registered Nurse (RN).
• Active state Clinical Social Work license.
• At least 3 years of professional practice experience.
• Valid driver’s license with car insurance.
• 3 to 5 years of Case/Care Management experience preferred.
• Must reside in NC.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable being themselves. We are committed to equity, acting with integrity and respect, and fostering an inclusive workplace. We celebrate diverse perspectives to enhance our vibrancy, innovation, and ability to serve communities.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Includes flexible work options, competitive pay, paid time off, health insurance from Day 1, 401(k), tuition reimbursement, and more.