Care Manager II

AmeriHealth Caritas; Rockingham (NC); Hybrid; USD 60,000 - 80,000; Full time

Job summary

AmeriHealth Caritas is seeking a Care Manager (RN/LCSW) to assist members in achieving their health goals through effective care coordination. This role involves comprehensive assessments, medication management, and collaboration with healthcare providers to ensure high-quality care. Join a mission-driven organization committed to making a difference in the community.

Benefits

Flexible work options including remote and hybrid schedules

Competitive pay

Paid time off including holidays and volunteer events

Health insurance coverage from Day 1

401(k) and tuition reimbursement

Qualifications

• Master’s Degree in Social Work required.
• Registered Nurse (RN) with active state license.
• 3 to 5 years of Case/Care Management experience preferred.

Responsibilities

• Assist members in achieving optimal health through care management.
• Conduct comprehensive assessments to determine care needs.
• Coordinate care with various health service providers.

Skills

Care Coordination

Medication Management

Assessment Skills

Communication

Education

Master’s Degree in Social Work

Registered Nurse (RN)

Active state Clinical Social Work license

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 activities within assigned AMH Tier III/CIN practices to ensure high-quality care management 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 care management needs for all referred members.
• 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 regular medication reconciliation and support of medication adherence.
• Identify problems and barriers for care coordination and appropriate care management interventions.
• Create a plan of care to assist members in reducing or resolving problems and barriers to achieve their health goals.
• Identify goals, set priorities, and assign timeframes for completion. Share goals with the member and family as appropriate.
• Implement appropriate level of intervention based on the member’s needs and progress.
• Schedule follow-up calls, make referrals, and document progress towards goals and problem resolution.
• Coordinate care with Care Coordinators, Community Health Navigators, members, caregivers, PCPs, specialists, and providers.
• Provide transitional care management and participate in meetings with AMH/CIN to ensure high-quality services.

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. Our commitment to equity means all associates have a fair opportunity to achieve their full potential. We act with integrity and respect, stand against injustice, and support a more inclusive and equitable workplace. Celebrating diverse perspectives makes our company more vibrant, innovative, and better equipped to serve our communities.

Our Comprehensive Benefits Package:

Flexible work options including remote, hybrid schedules, competitive pay, paid time off including holidays and volunteer events, health insurance coverage from Day 1, 401(k), tuition reimbursement, and more.