Care Manager II- RN or LSW

Care Manager II- RN or LSW

Location: Dublin, OH

Primary Job Function: Medical Management

ID: 37938

Your career starts now. We’re looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nations leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com .

Responsibilities:

The Care Manager II (RN/LSW) provides support to complex members appropriate for care coordination and case management services in achieving their optimal level of health through self-management. The Care Manager II (RN/LSW) is responsible for engaging the member, member caregiver, and providers to assess, plan, and establish individual member goals.

Assess members to determine care coordination and case management needs for all referred members.

Completes comprehensive person-centered assessment of physical health, psycho-social health, and environmental health as social determinants of health and supportive needs.

Identifies problems/barriers for care coordination and appropriate care management interventions.

Coordinates physical, behavioral health, and social services.

Provides medication management, including regular medication reconciliation and support of medication adherence.

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 both short- and long-term goals and associated time frames for completion. Share goals with the member and caregiver as appropriate.

Identifies and implements the appropriate level of intervention based on the member’s needs and clinical progress.

Schedules follow-up calls as necessary and makes appropriate referrals. Implements actions to address member issues. Documents progress towards meeting goals and resolving problems.

Coordinates care and services.

Education/Experience:

MUST LIVE IN OHIO, TO QUALIFY FOR CONSIDERATION

The work schedule is Monday through Friday from 8a to 5p EST.

Current and unrestricted Registered Nurse licensure in OH OR licensed Social Worker (LSW or LISW) in Ohio.

A Bachelors Degree (or higher) in a health-related field and licensure as a health professional (where such licensure is available)

Willing to meet face-to-face with members of the community, on occasion, based on business needs

A minimum of 3 years of clinical practice experience required working with Medicaid populations, either in the hospital or community health setting.

A minimum of 3 years of case management experience preferred in behavioral health.

Proficiency in utilizing MS Office (Word, Excel, Outlook, Teams) in a Windows-based environment, internet applications, and electronic medical record and documentation programs.

Valid drivers license, car insurance, and reliable vehicle.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable being themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

EOE Minorities/Females/Protected Veterans/Disabled