Healthcare Leader

3 days ago


Detroit, Michigan, United States AmeriHealth Caritas Full time
Job Title: Community Care Manager Senior, BSN

About the Role:

We are seeking a highly skilled and compassionate Community Care Manager Senior to join our team at AmeriHealth Caritas. As a key member of our Community Care Management Team, you will play a vital role in delivering comprehensive, outcomes-driven care to our members.

Key Responsibilities:

  • Collaborate with medical management teams to integrate community-based medical management programs and align with annual operating plans and strategic growth initiatives.
  • Assist in daily operations, including training and mentoring new and existing associates, participating in assigning and monitoring workflows, and policy development and enforcement.
  • Review referrals for appropriateness and assign episodes as needed.
  • Practice case management within the scope of licensure, managing a portion of a standard case load per plan needs and providing coverage for absent community care managers.
  • Provide access to a single point of contact for member questions or inquiries, conduct in-home environmental and physical assessments, and develop individualized care plans.
  • Ensure the provision of services in the least restrictive setting and transitions support across and between specialties and care settings.

Requirements:

  • Bachelor's Degree in Nursing required.
  • ~3+ years of Case Management experience preferred.
  • ~1+ year of community care management or home care experience is preferred.
  • ~Certification as a case manager documented and accepted.
  • Valid driver's license and car insurance required.

About AmeriHealth Caritas:

AmeriHealth Caritas is a national leader in healthcare solutions, passionate about helping people get care, stay well, and build healthy communities. We offer integrated managed care products, pharmaceutical benefit management, and specialty pharmacy services, as well as other administrative services.

What We Offer:

  • Diversity, Equity, and Inclusion
  • Flexible work solutions, including remote options and hybrid work schedules
  • Competitive pay and benefits
  • Time off, including holidays and volunteer events
  • Health insurance coverage for you and your dependents on Day 1
  • 401(k) and tuition reimbursement

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