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Pediatric Care Management RN II, BSN
2 months ago
We are seeking a dedicated RN Care Manager II with a BSN, specializing in pediatric shift care. The ideal candidate will possess a current and unrestricted RN license in Pennsylvania and have a minimum of 3 years of clinical experience working with medically fragile children. Experience in telephonic case management is also required. A valid driver's license and car insurance are necessary for conducting in-person visits with members.
About Us:
At AmeriHealth Caritas, we are committed to enhancing the health and well-being of individuals and communities. With over 30 years of experience, we provide comprehensive, outcomes-focused care to those who need it most. Our integrated managed care solutions, pharmaceutical benefits, and behavioral health services allow us to make a significant impact on the lives of millions.
Key Responsibilities:
- Assist members eligible for care management and coordination services to achieve their optimal health through effective self-management.
- Engage with members, caregivers, and healthcare providers to assess, plan, and establish personalized health goals.
- Facilitate and coordinate care while ensuring quality and cost-effective resource utilization.
- Act as a single point of contact and advocate for members within the care management program.
- Conduct telephonic assessments to determine care coordination and management needs.
- Complete comprehensive, person-centered assessments, including health history and supportive needs.
- Coordinate physical, behavioral health, and social services as necessary.
- Provide medication management, including regular reconciliation and adherence support.
- Identify barriers to care coordination and implement appropriate interventions.
- Create individualized care plans to help members overcome challenges and achieve health goals.
- Document progress towards goals and coordinate care with various healthcare providers.
Qualifications:
- Bachelor's Degree in Nursing.
- Current and unrestricted Registered Nurse licensure in Pennsylvania.
- Minimum of 3 years of clinical experience with medically fragile pediatric patients in acute care, home care, or special needs settings.
- At least 3 years of case management experience, preferably in a telephonic capacity within a managed care organization.
- Proficiency in using Windows 11 and MS Office applications, as well as electronic medical record systems.
- Must possess a valid driver's license and car insurance, with willingness to travel for work-related events.
Diversity, Equity, and Inclusion:
At AmeriHealth Caritas, we value diversity and strive to create an inclusive environment where all associates can thrive. We are committed to equity and respect, ensuring that everyone has the opportunity to reach their full potential. Our diverse workforce enhances our ability to serve the communities we support.
Benefits:
We offer a comprehensive benefits package, including flexible work solutions, competitive pay, health insurance coverage from Day 1, 401(k), tuition reimbursement, and more.
