Care Manager II - RN / LMSW / LPC w/w/ Behavioral Health Experience in New Castle County
Posted on: November 23, 2021
Your career starts now. We're looking for the next generation of
health care leaders.At AmeriHealth Caritas, we're passionate about
helping people get care, stay well and build healthy communities.
As one of the nation's leaders in health care solutions, we offer
our associates the opportunity to impact the lives of millions of
people through our national footprint of products, services and
award-winning programs. AmeriHealth Caritas is seeking talented,
passionate individuals to join our team. Together we can build
healthier communities. If you want to make a difference, we'd like
to hear from you.Headquartered in Philadelphia, AmeriHealth Caritas
is a mission-driven organization with more than 30 years of
experience. We deliver comprehensive, outcomes-driven care to those
who need it most. We offer integrated managed care products,
pharmaceutical benefit management and specialty pharmacy services,
behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.This role is
eligible for a $5,000 sign-on bonusResponsibilities:The Care
Manager/Coordinator (RN/SW) assists members appropriate for care
management and care coordination services in achieving their
optimal level of health through self-management. The Care
Manager/Coordinator (RN/SW) is responsible for engaging the member,
member care giver and providers to assess plan and establish
individual member goals. Will facilitate and coordinate care for
the members while assuring quality and use of cost-effective
resources. The position will function as a single point of contact
and be an advocate for members in the care coordination program. In
addition the Care Manager/Coordinator will oversee these same care
management activities within assigned practices to ensure the ACDE
delivers high quality care management services in accordance with
Plan, NCQA, Federal/State standards and requirements.
- Assess members through face to face encounter and by telephone
to determine care coordination and care management needs for all
- Completes comprehensive person centered assessment inclusive of
physical health history, mental health history, social determinants
of health and supportive needs.
- Coordinates physical, behavioral health and social
- Provides medication management, including regular medication
reconciliation and support of medication adherence;
- Identifies problems/barriers for care coordination and
appropriate care management interventions.
- Creates a plan of care to assist members in reducing/resolving
problems and or barriers so that members may achieve their optimal
level of health.
- Identifies goals and assigns priority with associated time
frames for completion. Shares goals with the member and family as
- Identifies and implements the appropriate level of intervention
based upon the member's needs and clinical progress.
- Schedules follow up calls as necessary, makes appropriate
referrals. Implements actions to address member issues. Documents
progress towards meeting goals and resolving problems.
- Coordinates care and services with the Community Health
Navigator, and member, member care giver as appropriate, PCP,
Specialist, and Facility/Vendor Providers.
- Provides transitional care management. Meets regularly with
designated partners regarding Plan identified members for care
management, assist with reducing/resolving problems and or barriers
so that the ACDE Care Coordinator may provide members with high
quality care management services.
- Participate in regularly scheduled meetings as
- Bachelor's Degree.
- Master's Degree.
- Registered Nurse.
- A bachelors (or higher) degree in a health related field and
licensure as a health professional (where such licensure is
available); or Certification as a case manager (as documented and
accepted on URAC's website@ www.urac.org); or MSW licensure and
three (3) years professional practice experience; and
- A Masters degree in a health related field and licensure as a
health professional (where such licensure is available); or
Certification as a case manager (as documented and accepted on
URAC's website@ www.urac.org); or MSW licensure and three (3) years
professional practice experience; and Active state RN license.
- Valid driver's license with car insurance.
- Current unrestricted Social Worker License.
- 3 to 5 years Case Management experience preferred.Back
Keywords: Amerihealth, Newark , Care Manager II - RN / LMSW / LPC w/w/ Behavioral Health Experience in New Castle County, Healthcare , Newark, Delaware
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