Under the supervision of the Manager of the Care Management Department, the Triage Care Manageris responsible for assisting Participants in coordinating care for Long Term Services & Supports. & closing care gaps. The Triage Care Manager will assist with Cases referred to the Special Needs Unit and complex cases referred by Service Coordination, Utilization Management ,or various other sources. Additionally, the Triage Care Manager will practice case management within the scope of their licensure for our Emergency Room Diversion cases (based on the standards of the discipline).
Work Arrangement
Remote with availability to work Eastern Standard Time 8:30am-5:00pm
Additional Triage Care Manager Responsibilities
Monitors the utilization of assigned participants over a time-limited period
Conducts assessments or surveys to identify problems/barriers for care coordination and appropriate intervention, including Participant education
Identifies and implements actions to address Participant issues
Collaborates with Medicare Care Managers from various MCOs to effectively coordinate care
Collaborates with nursing facilities and other providers of care to coordinate care
Notifies assigned Service Coordinators of service utilization and related care coordination
Makes referrals and appropriate follow-ups
Education
Bachelor's Degree in Nursing or health related field preferred.
Current and unrestricted Registered Nurse licensure in Pennsylvania or an Unrestricted Compact License.
Social Worker with a unrestricted Pennsylvania clinical license.
Experience
Registered Nurse, or Social Worker, graduated from an accredited Diploma from a Master's Degree program.
Minimum of 3 years of nursing experience, in a related clinical setting with Discharge Planning.
Proficiency with Microsoft Office Suite (Word, Excel, Power Point).
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.
Your career starts now. We’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 communities. As 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 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.