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Specialty Care Manager

2 months ago

Orlando, Florida, United States AmeriHealth Caritas Full time

Specialty Care Manager

Location: Orlando, FL

Primary Job Function: Medical Management

ID**: 34346

PerformSpecialty is a full-service specialty pharmacy. Our goal is to provide personalized patient care and better access to achieve healthier outcomes. Each patient works with a Patient Care Coordinator who, along with the prescriber, creates a program to treat each condition individually and works to involve the patient in his or her own health.

We know that successful treatment requires payers, patients, and pharmacies to work together. That's why we provide patients and payers with access to the most up-to-date information, 365 days a year. From our team of clinicians working around-the-clock to our integrated reporting tools, PerformSpecialty ensures that each component of the specialty treatment process is easily accessible.

PerformSpecialty also knows that patients using specialty drugs require attention above and beyond users of standard pharmaceuticals. The founders of PerformSpecialty have a long history of providing services for the underserved, a population in need of advanced care. Our history of meticulous oversight and individual attention enables us to provide unprecedented access, outcomes, and personalized care to all our specialty patients.

Responsibilities:

The Specialty Care Manager serves as a principal in the provision of PerformSpecialty's patient management program. Their duties are predominantly comprised of administering clinical assessments and providing clinical management and education to patients on service at PerformSpecialty. Additionally, they triage and assess patient concerns, questions and adverse events for escalation to a pharmacist or the prescriber.

The Specialty Care Manager is expected to be knowledgeable and proficient in the conditions we serve such that (s)he can administer assessments on multiple disease states, telephonically instruct patients on how to self-administer their medication, and provide care coordination with external resources including nursing/home health agencies, pharma and/or health plan stakeholders. The incumbent must be able to provide excellent documentation in the patient record, capturing all necessary clinical components in order to remain compliant with the goals of our patient management program.

In the course of providing care, the Care Manager is expected to provide clinically related information and evaluate the patient's ongoing need for the specific therapies treated by the medications dispensed at our specialty pharmacy. These include chronic diseases, terminal illnesses, genetic disorders, bleeding disorders, and others. The incumbent will also support operations by answering questions; researching information; completing requests, advising internal and external customer groups on drugs or drug therapies and disease states. The Care Manager will stay current on trends in nursing practice that affect our patient population and/or company operations.

The Specialty Care Manager also:

  • Ensure continuity of care by verifying, collecting, analyzing, organizing and reviewing patient data, medical histories, and evaluating, instructing, problem solving, according to specific plans of care for drug or drug therapies
  • Drive patient compliance by reviewing patient profiles, answering patient medical inquiries, contacting appropriate medical professionals and referring patients, when needed, to the appropriate departments to ensure adherence to plan of care
  • Collaborate with all staff team members to ensure team effectiveness and productivity and offering suggestions for improvement
  • Follow all internal processes and procedures to ensure activities are handled in accordance with departmental and company policies and procedures
  • Perform other duties as assigned by the Care Manager Supervisor or the Director of Pharmacy

Education/Experience:

  • Active/current FL Registered Nurse required
  • Minimum five (5) years of professional nursing practice experience required
  • Clinical experience in specialty areas such as home infusion, hospital inpatient, Physician specialty groups (Oncology, Hematology, Neurology, etc.) required

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations 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 would like to connect with 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

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

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

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, competitive pay, Paid Time Off (PTO) including holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k), tuition reimbursement, and more.

EOE Minorities/Females/Protected Veterans/Disabled