Care Manager II

Amerihealth Caritas•Washington, DC

1d•$83,400 - $113,600•Hybrid

About The Position

The Care Manager assists members who are appropriate for care management and care coordination services in achieving their optimal level of health through self-management. The role engages members, their caregivers, and providers to assess needs, plan care, and establish individual goals. The Care Manager facilitates and coordinates care while ensuring quality and cost-effective use of resources, and serves as a single point of contact and advocate for members in the care management program. This is an in-office position based in the DC metro area. The schedule is Monday through Friday, 8:30 AM to 5:00 PM EST, with four days per week in the DC office at 1201 Maine Ave SW and one day remote. The role requires direct face-to-face visits with identified members in the community as needed. Associates are responsible for commuting costs, and the company offers a commuter benefit program.

Requirements

For RN candidates: current and unrestricted Registered Nurse licensure in the District of Columbia and an Associate’s Degree in Nursing.
For LICSW candidates: current and unrestricted Licensed Independent Clinical Social Worker licensure in the District of Columbia and a Master’s Degree in Social Work.
At least 3 years of independent clinical practice experience as an RN or LICSW working with complex medical and behavioral health diagnoses in acute care, home care, or community health settings.
Active and unencumbered RN or LICSW licensure in the District of Columbia.
Proficiency in MS Office (Word, Excel, Outlook, and Teams), internet applications, and electronic medical record/documentation systems.
Must reside in the DC metro area.

Nice To Haves

At least 1 year of case management experience supporting complex adult and pediatric Medicaid populations within a managed care organization is preferred.

Responsibilities

Assess referred members by face-to-face or telephone contact to determine care coordination and care management needs.
Complete a comprehensive, person-centered assessment covering physical and mental health history, social determinants of health, and supportive needs.
Coordinate physical health, behavioral health, and social services.
Provide medication management, including regular medication reconciliation and support for medication adherence.
Identify care coordination problems and barriers and select appropriate care management interventions.
Create a plan of care to help members reduce or resolve problems and barriers and achieve their optimal level of health.
Identify goals, prioritize them, and assign time frames for completion; share goals with members and families as appropriate.
Identify and implement the appropriate level of intervention based on members’ needs and clinical progress.
Schedule follow-up calls as needed, make appropriate referrals, implement actions to address member issues, and document progress toward goals and problem resolution.
Coordinate care and services with the Care Coordinator, Community Health Navigator, member, caregiver as appropriate, PCP, specialist, complex adult and pediatric populations, and facility/vendor providers.
Conduct face-to-face visits with identified members in the community as needed.