Registered Nurse Care Coordinator II, Special Needs

2 weeks ago

Philadelphia, Pennsylvania, United States Amerihealth Caritas Health Plan Full time
Registered Nurse Care Coordinator II, Special Needs

Your career journey begins here. We are in search of the next wave of healthcare leaders.

At AmeriHealth Caritas, we are dedicated to assisting individuals in accessing care, maintaining wellness, and fostering healthy communities.

As a prominent entity in healthcare solutions, we provide our team members the chance to make a significant impact on the lives of countless individuals through our extensive range of products, services, and award-winning initiatives.

AmeriHealth Caritas is eager to welcome skilled and passionate professionals to our team. Together, we can cultivate healthier communities. If you aspire to make a difference, we invite you to connect with us.

As a mission-driven organization with over 30 years of experience, AmeriHealth Caritas is headquartered in Newtown Square. We deliver comprehensive, outcome-focused care to those who require it the most.

Our offerings include integrated managed care products, pharmaceutical benefit management, specialty pharmacy services, behavioral health services, and various administrative solutions.

Learn more about us at

Key Responsibilities:


The Care Coordinator II supports members eligible for care coordination and case management services in achieving their best health outcomes.

The Care Coordinator II is tasked with engaging members and healthcare providers to evaluate, plan, and set individual health goals.

This role will facilitate and coordinate care for members while ensuring quality and the utilization of cost-effective resources.

The position serves as a single point of contact and advocates for members within the care coordination program.

Assess members to identify care coordination and case management requirements for all referred individuals. Conduct comprehensive evaluations of environmental, psychosocial, and support needs. Identify challenges/barriers to care coordination and implement suitable care management strategies.

Develop a care plan to assist members in overcoming challenges and achieving their optimal health.

Establish both short-term and long-term goals along with timelines for completion. Communicate goals with the member and their family as appropriate. Determine and apply the necessary level of intervention based on the member's needs and clinical progress. Schedule follow-up communications as required and make appropriate referrals. Execute actions to address member concerns. Document progress towards achieving goals and resolving issues. Coordinate care and services with the member, family members as appropriate, primary care providers, specialists, and facility/vendor providers.

Qualifications:

  • Ability to travel as needed to meet with members.
  • Bachelor's Degree in Nursing.
  • Current and unrestricted Registered Nurse licensure.
  • A minimum of 3 years of experience in case management, preferably in a managed care environment.
  • At least 3 years of professional clinical practice experience as a Registered Nurse is required. Preferred settings include emergency care or home health.
  • Experience in behavioral health, including managing care for individuals with mental health and substance use disorders, life stressors, and crises.
  • Proficiency in MS Office (Word, Excel, Outlook), internet applications, and electronic medical record systems.
  • Eligible for Case Management Certification within 12 months of starting the position. Successful attainment of Case Management certification is required.
  • Valid driver's license and car insurance.
Diversity, Equity, and Inclusion

At AmeriHealth Caritas, we strive to create an environment where everyone feels valued, supported, and free to express themselves. Our commitment to equity ensures that all team members have a fair opportunity to reach their full potential. We embody these principles daily by acting with integrity and respect.

We unite to advocate against injustice and dismantle barriers to foster a more inclusive and equitable workplace.

By celebrating and embracing the diverse perspectives that comprise our workforce, we enhance our company’s vibrancy, innovation, and capacity to support the individuals and communities we serve.

We prioritize the well-being of our associates so they can focus on the health of our members.

Our Comprehensive Benefits Package


Flexible work arrangements, including remote options, hybrid schedules, competitive compensation, paid time off including holidays and volunteer opportunities, health insurance coverage for you and your dependents from day one, 401(k), tuition reimbursement, and more.

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