Job Description

Role Overview

The Care Manager (RN) assists members appropriate for care management and care coordination services in achieving their optimal level of health through self-management. The Care Manager (RN) is responsible for engaging the member, the member caregiver, and providers to assess, plan, and establish individual member goals. Will facilitate and coordinate care for the members while assuring quality and the 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 will oversee these same care management activities within assigned practices to ensure the ACDC delivers high-quality care management services according to Plan, NCQA, and Federal/State standards and requirements.

$5,000.00 Sign On Bonus

Responsibilities:

• Assess members by telephone to determine care coordination and care management needs for all referred members.
• Completes a comprehensive person-centered assessment that includes physical health history, mental health history, social determinants of health, and supportive needs.
• Coordinates physical, behavioral health, and social services.
• Provides medication management, including regular medication reconciliation and medication adherence support.
• 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 appropriate.
• 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, the member, the member caregiver as appropriate, the PCP, the Specialist, and the Facility/Vendor Providers.
• Meets regularly with designated partners regarding Plan identified members for care management, assists with reducing/resolving problems and/or barriers so that the ACDC Care Coordinator may provide members with high-quality care management services.
• Participate in regularly scheduled meetings as needed.
  
   

Education & Experience:

• 3 to 5 years of case management experience preferred.
  
   

Licensure:

• Active DC RN license.

The range displayed in this job posting reflects the minimum and maximum for new hire salaries for the position in the Washington, DC area. 
Within the range, individual pay is determined by additional factors, including, without limitation, job-related skills, experience, and relevant education, certifications, or training. AmeriHealth Caritas associates are eligible to participate in our annual incentive program and will also receive our benefits package, which includes medical, vision, dental, life insurance, disability insurance, 401(k), paid time off, and more. The targeted hiring range for this role is expected to be between $78,600.00 and $107,100.00.

Your career starts now. We’re looking for the next generation of healthcare 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 healthcare 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. We'd like to hear from you if you want to make a difference.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with over 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  . 

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, including holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k), tuition reimbursement, and more.

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