Care Manager II (B)

Amerihealth Caritas•,

12d•Remote

About The Position

The Care Manager supports members in achieving optimal health through self-management. Engaging with members, caregivers, and providers, the role involves assessing plans, setting individual goals, and coordinating care to ensure quality and cost-effective resources. This position serves as a single point of contact and advocate for care coordination program members, overseeing care management activities within assigned practices to meet Plan, NCQA, Federal/State standards.

Requirements

Associate's Degree in Nursing (for RN candidates) or Master's Degree in Social Work (for Licensed Social Work candidates).
Minimum of 3 years of independent clinical practice experience (including homecare, community health, or public health).
Proficiency using MS Office (Teams, Word, SharePoint, Excel, and Outlook).
Ability to type with accuracy and speed.
Clear, concise, and collaborative written and verbal communicator.
Must be bilingual, demonstrating the ability to speak both English and Haitian Creole, Spanish, or Russian.
Active and unencumbered compact state Registered Nurse license OR Active and unencumbered Social Work license.
Ability to meet productivity measures through outreach calls and assessment and screening surveys to members.

Nice To Haves

Bachelor's Degree (preferred for RN candidates).
Minimum of 3 years of case management experience.

Responsibilities

Conduct telephone assessments to determine care coordination and management needs.
Complete comprehensive person-centered assessments covering physical and mental health history, social determinants, and supportive needs.
Coordinate physical, behavioral health, and social services.
Manage medications, including reconciliation and adherence support.
Identify problems/barriers and implement appropriate care management interventions.
Develop care plans to help members achieve optimal health, setting goals and priorities.
Share goals with members and families as appropriate.
Implement interventions based on member needs and clinical progress.
Schedule follow-up calls and make referrals as necessary.
Document progress towards goals and problem resolution.
Coordinate care with Community Health Navigators, caregivers, PCPs, specialists, and facility/vendor providers.
Meet regularly with partners to address care management issues and ensure high-quality services.
Participate in scheduled meetings as needed.