Job Brief

We prefer a Social Worker (LMSW) with one or more of the following: LMHP, LCSW, LPC, LM & Family Therapists (LMFT) or a LAC.

Responsibilities:

Under the Direction of the Supervisor, the Transition Care Manager is responsible for completing preventative multidisciplinary discharge planning for plan member presenting to the Emergency Room and / or Acute Setting using AmeriHealth Caritas policies and procedures. The Transition Care Manager will assess and processes discharge planning needs across all disciplines including necessary case management referrals.

This position may include the following responsibilities: consistent application of medical health benefit policy and medical management guidelines to authorize services, appropriately identifies and refers requests to the Medical Director when guidelines are not met, review of daily ER or inpatient census of plan members, receive and process facility referrals, face to face interaction with plan members, complete survey to identify plan member needs, identify gaps in care, determine members understanding of illness and outpatient management of illness in addition to evaluating and coordinating and implementing discharge needs for all short and long term needs across disciplines including but not limited to PCP, home care, skilled nursing and rehabilitation services, DME, pharmacy, case management and/ or social worker referral for community needs and availability, scheduling appointments and arranging critical follow-up calls for care coordination, and member education on how and where to seek appropriate care and follow-up services.

• Education/Experience:

• An unrestricted RN or LMSW to practice in the state of Louisiana.
• Registered Nurse with an Active/Clear license in the state of Louisiana. Must have behavioral health experience.
  • BSN or equivalent education and experience required for an RN.
• Social Worker (MS) and:
  • LMPH - Licensed Mental Health Professionals (LMHP).
  • Licensed Clinical Social Workers (LCSW).
  • Licensed Professional Counselors (LPC).
  • Licensed Marriage and Family therapists (LMFT).
  • Licensed Addiction Counselors (LAC).

• Other Needs:

• Minimum of 3 years SW/nursing experience, in related behavioral health clinical setting.
• Managed care experience preferred.
• Emergency Room or Acute Discharge Planning Experience Preferred.
• Valid driver’s license w/auto insurance required
• This is a remote, work from home position that will require telephonic and face-to-face interactions with our members in off-site locations such as their homes, provider offices and/or hospitals.
• Selected candidate must reside in Louisiana Department of Health Region 4 and be able to serve the region. The principal city there is Lafayette, LA.

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