Care Manager II RN/LMSW | Remote in South Carolina at AmeriHealth Caritas

Job Brief

This role is remote however the selected candidate must reside in South Carolina.

Candidates must reside in the state of South Carolina

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 Newtown Square, Pennsylvania, 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.

Summary:

The Care Manager II (RN/LMSW) is a Telephonic role that assists members appropriate for care management and care coordination services in achieving their optimal level of health through self-management.

Responsibilities:

• Responsible for engaging the member and providers to assess, plan and establish individual member goals


• Facilitate and coordinate care for the members while assuring quality and use of cost-effective resources


• Assess members to determine care coordination and case management needs for all referred members


• Completes comprehensive assessment of environmental, Psycho-social and support needs


• 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 both short and long term goals and 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 members' 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 member, family members as appropriate, PCP, Specialist, and Facility/Vendor Providers

Education/Experience:

• Bachelor of Science in Nursing (BSN) is required and must hold a current and unrestricted Registered Nurse (RN) license in good standing in South Carolina or an MSW with current unrestricted Social Work License in South Carolina


• Minimum three (3) years of Case Management experience preferred


• Minimum three (3) years professional experience preferred


• Prior experience in Behavioral Health preferred


• Proficiency in MS Office (Word, Excel, Outlook, Teams), internet applications, and electronic medical record/documentation systems is essential


• Valid driver’s license with car insurance required

Diversity, Equity, and Inclusion

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

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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