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Pediatric RN Care Coordinator II
2 months ago
The Pediatric RN Care Manager II plays a crucial role in guiding members towards achieving their highest health potential through effective care management and coordination. This position is essential for engaging with members, their caregivers, and healthcare providers to assess, plan, and set personalized health goals.
Key Responsibilities:
- Conduct assessments of members through in-person meetings or telephonic interactions to identify care coordination and management needs.
- Perform comprehensive evaluations that encompass physical health history, mental health background, social determinants of health, and additional support requirements.
- Facilitate the integration of physical, behavioral health, and social services.
- Oversee medication management, ensuring regular reconciliation and adherence support.
- Identify barriers to care coordination and implement suitable management interventions.
- Develop individualized care plans aimed at resolving issues and enhancing members' health outcomes.
- Set and prioritize goals with defined timelines for achievement, sharing these objectives with members and their families as appropriate.
- Implement interventions tailored to the member's needs and clinical advancements.
- Schedule follow-up communications as necessary, making appropriate referrals and documenting progress towards established goals.
- Coordinate services with Care Coordinators, Community Health Navigators, and other healthcare providers to ensure comprehensive care.
- Provide transitional care management, collaborating with relevant teams to enhance care quality for identified members.
Qualifications:
- Bachelor's Degree in Nursing.
- Active and unrestricted Registered Nurse license in Pennsylvania.
- A minimum of 3 years of clinical experience as a Registered Nurse, particularly with medically fragile pediatric patients in various care settings.
- At least 3 years of experience in Case Management, preferably in a telephonic capacity within a managed care framework.
- Eligibility to pursue Case Management certification after one year of employment, with a requirement to obtain it thereafter.
- Proficient 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 travel for in-person member visits as needed.
Diversity, Equity, and Inclusion Commitment
At AmeriHealth Caritas, we strive to create 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 in our workplace, fostering a culture that embraces diverse perspectives and ideas.
Comprehensive Benefits Package
We offer flexible work arrangements, competitive compensation, health insurance from Day 1, 401(k) plans, tuition reimbursement, and generous paid time off, including holidays and volunteer opportunities.
