Care Manager

Amerihealth Caritas•Washington, DC

6d•$83,400 - $113,600•Hybrid

About The Position

The In-Office Care Manager (RN/LICSW) helps members who are appropriate for care management and care coordination achieve their optimal level of health through self-management. The Care Manager engages members, caregivers, and providers to assess needs, develop plans, and establish individual goals. The role facilitates and coordinates care while promoting 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 Eastern Time, with four days per week in the DC office at 1201 Maine Ave SW and one remote day. The role also requires direct face-to-face visits with identified members in the community as needed. Associates are responsible for commuting costs; a commuter benefit program is available.

Requirements

For RN candidates: current, unrestricted Registered Nurse licensure in the District of Columbia and an Associate’s Degree in Nursing.
For LICSW candidates: current, 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 Registered Nurse (RN) licensure in the District of Columbia or active and unencumbered Licensed Independent Clinical Social Worker (LICSW) licensure in the District of Columbia.
Proficiency in MS Office (Word, Excel, Outlook, Teams), internet applications, and electronic medical record and documentation systems.
Must reside in the DC metro area.

Nice To Haves

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

Responsibilities

Assess referred members through face-to-face visits or telephone calls to determine care coordination and care management needs.
Complete comprehensive, person-centered assessments covering physical and mental health history, social determinants of health, and supportive needs.
Coordinate physical, behavioral health, and social services.
Provide medication management, including regular medication reconciliation and support for medication adherence.
Identify care coordination problems and barriers and determine appropriate care management interventions.
Create plans of care to help members reduce or resolve problems and barriers and achieve optimal health.
Identify goals and prioritize them with associated completion time frames; share goals with members and families as appropriate.
Select and implement the appropriate level of intervention based on members’ needs and clinical progress.
Schedule follow-up calls as necessary, make appropriate referrals, take action 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 and vendor providers.