Care Manager II

1 week ago


Dover, Delaware, United States AmeriHealth Caritas Full time
About the Role

AmeriHealth Caritas is seeking a skilled Care Manager II to join our team in Bright Start Maternity. As a key member of our care management team, you will play a vital role in ensuring our members receive high-quality, patient-centered care.

Responsibilities
  • Assess members' care coordination and care management needs through face-to-face encounters and telephone calls.
  • Conduct comprehensive person-centered assessments, including physical health history, mental health history, social determinants of health, and supportive needs.
  • Coordinate physical, behavioral health, and social services to support members' optimal health outcomes.
  • Provide medication management, including regular medication reconciliation and support of medication adherence.
  • Identify problems and barriers to care coordination and implement appropriate care management interventions.
  • Create a plan of care to assist members in reducing or resolving problems and achieving their optimal level of health.
  • Identify goals and assign priority with associated timeframes for completion; share goals with members and family as appropriate.
  • Implement the appropriate level of intervention based on members' needs and clinical progress.
  • Schedule follow-up calls as necessary and make appropriate referrals.
  • Coordinate care and services with community health navigators, members, caregivers, primary care physicians, specialists, and facility/vendor providers.
  • Provide transitional care management and meet regularly with designated partners regarding plan-identified members for care management.
Requirements
  • Associate Degree in Nursing is required.
  • Bachelor's (or higher) degree in a health-related field is preferred.
  • Current and unrestricted RN licensure in Delaware is required.
  • Minimum of 3 years of labor & delivery, postpartum, and/or OBGYN office experience.
  • Minimum of 3 years of experience as a Case Manager, preferably providing telephonic case management.
  • Certification as a case manager is preferred.
  • Ability to meet deliverables within designated timeframes, strong organization, and communication skills.
  • Proficiency using MS Office (Word, Excel, Outlook), internet applications, and electronic medical record and documentation programs.
  • Ability to travel within Kent County for home visitations (possibility of 50% travel required).
What We Offer

AmeriHealth Caritas is committed to providing a comprehensive benefits package that supports the well-being of our associates. Our benefits include:

  • Flexible work solutions, including remote options and 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) and additional non-elective contributions, starting on Day 1.
  • Employee assistance programs, fitness reimbursements, nutrition counseling, and more.
  • Employer-paid life insurance, with opportunities to purchase additional coverage.
  • Employer-paid short-term disability coverage and long-term disability coverage.
  • Tuition assistance, including reduced tuition at certain schools.
  • Financial assistance with adoption, including paid time off.
  • Flexible spending and health savings accounts to pay for qualified expenses.
  • Discount programs on entertainment, travel, and more.


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