Care Manager

Amerihealth Caritas•Washington, DC

65d•$83,400 - $113,600•Hybrid

About The Position

The In-Office Care Manager (RN/LICSW) assists members appropriate for care management and care coordination services in achieving their optimal level of health through self-management. The Care Manager (RN/LICSW) is responsible for engaging the member, member's caregiver and providers to assess, plan, and establish individual member goals. Will facilitate and coordinate care for the members while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for members in the care management program.

Requirements

Current and unrestricted Registered Nurse licensure in the District of Columbia (for RN candidates)
Associate’s Degree in Nursing (for RN candidates)
Current and unrestricted Licensed Independent Clinical Social Worker (LICSW) licensure in the District of Columbia (for LICSW candidates)
Master’s Degree in Social Work (for LICSW candidates)
Minimum of 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
Proficiency in MS Office (Word, Excel, Outlook, Teams), internet applications, and electronic medical record/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 preferred

Responsibilities

Assess members through face-to-face or telephone calls 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 support of medication adherence
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. As appropriate, shares goals with the member and family
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 Care Coordinator, Community Health Navigator, member, member's caregiver as appropriate, PCP Specialist, complex adulat and pediatric populations and Facility/Vendor Providers