Community Care Manager

Amerihealth Caritas•Southfield, MI

3d•Remote

About The Position

The Community Care Manager assists members appropriate for care coordination and case management program services in a community setting. This role requires the associate to reside in the state of Michigan (MI), with a preference for Wayne, Oakland, and Macomb counties. The position is remote but requires travel for home visits.

Requirements

Bachelor’s degree in nursing or social work required.
Current, active, and unrestricted Registered Nurse (RN) or Licensed Master Social Worker (LMSW) in MI
1 year of experience conducting health assessments and delivering care in a clinical and community environment
Valid driver’s license with car insurance.
Strong clinical assessment skills with the ability to evaluate member needs and identify barriers to care
Strong communication and interpersonal skills, with the ability to engage members and collaborate with interdisciplinary teams
Ability to educate and coach members on disease management and self-care strategies
Critical thinking and problem-solving skills to address complex member needs and resolve care issues
Strong organizational and time management skills
Ability to collaborate with and provide guidance to team members
Knowledge of healthcare regulations, accreditation standards, and compliance
Proficiency with documentation systems, care management platforms, and Microsoft Office tools

Nice To Haves

preferred counties include Wayne, Oakland, and Macomb

Responsibilities

Serves as a single point of contact for member questions and inquiries
Conducts in-home environmental and physical assessments for high-risk members to identify unmet needs and barriers to care
Develops and maintains individualized care plans, ensuring they are regularly reviewed and updated
Provides disease self-management education and coaching within scope of practice
Performs medication reviews, including reconciliation during transitions of care
Ensures care is delivered in the least restrictive setting and supports transitions across specialties and care settings
Connects members to community-based resources that promote independent living and help delay or prevent nursing facility placement
Establishes and maintains collaborative relationships with community, medical, and behavioral health teams
Works closely with and oversees Community Care Navigators to facilitate access to appropriate in-community services
Serves as a program subject matter expert and supports the Community Care Program Manager with operational activities as needed