Care Manager

Care Manager (RN)

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, 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.

Role Overview

The Care Manager (RN) assists members appropriate for case management services in achieving their optimal level of health. The Care Manager II is responsible for engaging the member 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.

Responsibilities

• Conduct telephone assessments to determine care management needs for all referred members
• Complete comprehensive person-centered assessments covering physical and mental health history, social determinants, and supportive needs
• Coordinate physical, behavioral health, and social services
• Manage medications, including reconciliation and adherence support
• Identify problems/barriers and implement appropriate care management interventions
• Develop care plans to help members achieve optimal health, setting identified goals
• Share goals with members and families as appropriate
• Implement interventions based on member needs and clinical progress
• Schedule follow-up calls and make referrals as necessary
• Document progress towards goals and problem resolution
• Coordinate care with Community Health Navigators, caregivers, PCPs, specialists, and facility/vendor providers
• Meet regularly with partners to address care management issues and ensure high-quality services
• Participate in scheduled meetings as needed

Work Arrangement

Remote. Must reside in state of Pennsylvania.

Education

Associate's Degree in Nursing (RN) required

Licensure

Current and unrestricted Registered Nurse licensure in Pennsylvania required. Valid driver's license with car insurance.

Experience

Minimum of 3 years clinical practice experience in medical-surgical and/or home care required. Experience with behavioral health desired. Minimum of three years of experience as a case manager, preferably providing telephonic case management. Certification as a case manager preferred.

Skills and Abilities

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.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, competitive pay, paid time off including holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k), tuition reimbursement and more. As a company, we support internal diversity through: recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.