Care Manager II, Pediatric Shift Care, Registered Nurse, REMOTE
Job description
Your career starts now. We’re looking for the next generation of health care leaders.
At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care 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 Philadelphia, 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.
Under the supervision of the Supervisor, Care Coordination, the Care Manager assumes the overall accountability for the identification of members appropriate for care coordination and/or case management program services. Completes a comprehensive case management assessment and gathers pertinent information about the Member's needs by interviewing the M/C, appropriate family members, physicians, ancillary health professionals and others as necessary; some community facing visits may be required. Is responsible for the development of the Member's interdisciplinary individualized plan of care including short term and long term goals in collaboration with the M/C. Monitors and evaluates the M/C’s progress towards meeting goals and initiates appropriate interventions as necessary. Serves as an advocate for the member and acts as a liaison between the Member and other community based agencies, facilities, providers, and practitioners in coordinating the Member's care. Refers Member as appropriate for other services such as Special Needs and Pharmacy. Pediatric case management experience recommended.
Education/ Experience:
- Current and unrestricted Registered Nurse license in Pennsylvania required.
- Minimum of 3 years of experience providing direct patient care (as a Registered Nurse) to the medically fragile pediatric population within an acute care and/or home care setting.
- 3 to 5 years of experience working as a case manager, preferably telephonic in nature, desired.
- Experience working in a managed care organization preferred.
- Case Management Certification preferred (as documented and accepted on URAC’s website@ www.urac.org).
- Demonstrated attention to detail, strong organizational and time management skills, and experience identifying and coordinating community resources to provide additional support to members and caregivers.
- Demonstrated proficiency working within a Windows 10 environment to include MS Office and electronic medical record and documentation programs.
- Valid driver’s license and car insurance.
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