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Pediatric RN Care Coordinator II
2 months ago
The Pediatric Care Manager II plays a crucial role in supporting members with care management and coordination services to help them achieve their highest level of health through effective self-management. This position involves engaging with members, their caregivers, and healthcare providers to assess, plan, and set individual health goals.
Key Responsibilities:
- Conduct assessments of members via in-person visits or telephonic communication to identify care coordination and management needs.
- Perform comprehensive, person-centered evaluations that include physical health history, mental health background, social determinants of health, and necessary support services.
- Facilitate coordination of physical health, behavioral health, and social services.
- Manage medication, ensuring regular reconciliation and adherence support.
- Identify challenges and barriers to effective care coordination and implement suitable management interventions.
- Develop individualized care plans aimed at addressing problems and barriers, enabling members to reach their optimal health.
- Set specific goals with associated timelines for completion, sharing these objectives with members and their families as appropriate.
- Determine and apply the necessary level of intervention based on the member's unique needs and clinical progress.
- Schedule follow-up communications as needed, make appropriate referrals, and document progress towards goal achievement.
- Collaborate with Care Coordinators, Community Health Navigators, and other healthcare providers to ensure comprehensive care delivery.
- Provide transitional care management, engaging regularly with care management teams to enhance the quality of services offered to members.
Qualifications:
- Bachelor's Degree in Nursing.
- Current and valid Registered Nurse licensure in Pennsylvania.
- A minimum of 3 years of clinical experience as a Registered Nurse, particularly with medically fragile pediatric patients in various settings.
- At least 3 years of experience in Case Management, preferably in a telephonic capacity within a managed care environment.
- Eligibility to pursue Case Management certification after 12 months of employment, with a requirement to obtain certification within one year.
- Proficiency in using Windows 11 and MS Office applications, along with electronic medical record systems.
- Possession of a valid driver's license and car insurance, with a willingness to use a personal vehicle for member visits as necessary.
Diversity, Equity, and Inclusion Commitment
At AmeriHealth Caritas, we prioritize creating an environment where every individual feels valued and respected. Our dedication to equity ensures that all associates have the opportunity to reach their full potential. We actively promote integrity and respect, standing against injustice and fostering an inclusive workplace. Embracing diverse perspectives enhances our organization, enabling us to better serve the communities we support.
Comprehensive Benefits
We offer flexible work arrangements, competitive compensation, health insurance coverage from day one, a 401(k) plan, tuition reimbursement, and generous paid time off, including holidays and volunteer opportunities.
