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Pediatric Care Coordination Manager, RN
2 months ago
At AmeriHealth Caritas, we are dedicated to fostering the next generation of healthcare leaders. Our mission is to empower individuals to access care, maintain wellness, and cultivate thriving communities.
As a prominent entity in healthcare solutions, we provide our team members with the opportunity to make a significant impact on the lives of countless individuals through our extensive range of products, services, and award-winning initiatives.
Role Overview:
The Pediatric Care Coordination Manager plays a crucial role in assisting members eligible for care coordination and case management services, guiding them towards achieving their best health outcomes. This position is responsible for facilitating and coordinating care while ensuring quality and the efficient use of resources.
Key Responsibilities:
- Act as an advocate for members within the care coordination program.
- Evaluate members to identify their care coordination and case management requirements.
- Conduct comprehensive in-home assessments—physical, psycho-social, and environmental—for complex pediatric cases to uncover unmet needs and barriers to care.
- Develop tailored care plans aimed at addressing barriers and facilitating optimal health for pediatric members requiring home care services. Establish both short-term and long-term goals with defined timelines for achievement, and document progress towards these objectives.
- Collaborate with members, their families, Pediatric Shift Care team members, account managers, primary care providers, specialists, facility/vendor providers, and community partners to ensure coordinated care.
Qualifications:
- Bachelor's degree is preferred.
- A minimum of three years of clinical experience working with medically fragile pediatric patients in either acute care or home care settings is required.
- Experience in case management within a managed care organization is preferred.
- Proficiency in MS Office applications (Word, Excel, Outlook) in a Windows environment, as well as familiarity with electronic medical records (EMRs) and electronic documentation systems.
- A valid driver's license and current car insurance are required.
- Must be eligible for certification in case management within 12 months of accepting the position, with successful attainment of certification required within 18 months of employment.
- Completion of medical examinations and testing as mandated by federal and state regulations is required upon conditional offer of employment and post-employment.
Diversity, Equity, and Inclusion:
We celebrate and embrace the diverse perspectives that enrich our workforce, making our organization more vibrant and innovative, and better equipped to support the communities we serve.
Benefits:
We offer flexible work solutions, including remote options and hybrid schedules, competitive compensation, paid time off (including holidays and volunteer opportunities), comprehensive health insurance coverage from day one, a 401(k) plan, tuition reimbursement, and more.
