Healthcare Advocate

3 weeks ago


Florence, South Carolina, United States AmeriHealth Caritas Full time
Job Summary:
AmeriHealth Caritas is seeking a dedicated Care Manager II Registered Nurse to join our team. This rewarding role requires the candidate to reside in South Carolina, with a preference for candidates in York, Florence, Darlington, Williamsburg, and Horry counties.

About Us:
We are a mission-driven organization committed to providing comprehensive care and building healthier communities. Our company culture values collaboration, learning, and professional growth.

Job Description:
This telephonic Care Manager role involves leading the charge in monitoring and updating care plans. You will use real-time feedback from members and caregivers to refine your approach and ensure that care meets their evolving needs. Collaborating closely with other healthcare professionals, you will serve as a vital link in the chain of care.

Responsibilities:
- Support members through transitions of care by assessing and coordinating care plans, educating on discharge plans, making referrals, and evaluating effectiveness.
- Review medication lists to educate members on pharmacy needs, counseling them on potential side effects.
- Regularly follow up with members/caregivers to monitor and update care plans based on progress and preferences.
- Establish contact points to collaborate with community and medical teams.
- Maintain timely and accurate documentation of member interactions in the electronic care management systems.
- Ensure proper service utilization and coordinate with other payers, making referrals as necessary.
- Develop a comprehensive knowledge of care management programs, community resources, and applicable regulations.
- Identify cases for care management rounds and follow up on provider recommendations.
- Promote a positive workplace environment by collaborating and sharing knowledge to support our diverse member population.

Requirements:
- Must reside in South Carolina.
- A Bachelor of Science in Nursing (BSN) and a current unrestricted Registered Nurse (RN) license in good standing.
- At least 3 years of professional experience in pediatric home care or acute care required.
- Preferred experience in the Foster Care System, Social Services, or Juvenile Justice.
- Case management experience of at least 3 years is preferred.
- Proficiency in MS Office and electronic medical records is essential.
- A valid driver's license with car insurance is required.

Salary:$63,000 - $75,000 per year

Benefits:
We offer a comprehensive benefits package that includes flexible work solutions, competitive pay, comprehensive health insurance for you and your dependents, paid time off, 401(k), tuition reimbursement, and more.

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